Provider Demographics
NPI:1851392005
Name:OLSON, PETER RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:RALPH
Last Name:OLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:ALLEGHENY PATHOLOGY ASSOCS
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-6886
Mailing Address - Fax:412-359-3598
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:ALLEGHENY PATHOLOGY ASSOCS
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-6886
Practice Address - Fax:412-359-3598
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018652E207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012315030005Medicaid
WV3810002458Medicaid
OH2227647Medicaid
PA0012315030001Medicaid
WV3810002458Medicaid
PA0012315030001Medicaid
PACG2169Medicare PIN
OH2227647Medicaid