Provider Demographics
NPI:1750357018
Name:OLSON, DENISE MARIE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 EAST CARVER ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704
Mailing Address - Country:US
Mailing Address - Phone:919-471-2273
Mailing Address - Fax:919-479-0881
Practice Address - Street 1:209 EAST CARVER ST
Practice Address - Street 2:DURHAM WOMENS CLINIC
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704
Practice Address - Country:US
Practice Address - Phone:919-471-2273
Practice Address - Fax:919-479-0881
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300266207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07-50121OtherUHC
NC8964081Medicaid
NC154766OtherWELLPATH
NC562142486V5OtherCIGNA
NC64081OtherBCBS
NC562142486OtherAETNA
NC562142486OtherBEECHSTREET
NC46826OtherMEDCOST
NC07-50121OtherUHC
NC154766OtherWELLPATH