OLSEN, ANDREW J (MD)

Provider Demographics

• NPI: 1831383173
• Name: OLSEN, ANDREW J (MD)
• Entity type: Individual
• Prefix: DR
• First Name: ANDREW
• Middle Name: J
• Last Name: OLSEN
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: 10800 E GEDDES AVE STE 300
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112-3895
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 10800 E GEDDES AVE STE 300
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80112-3895
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-874-4462
• Is Sole Proprietor?: No
• Enumeration Date: 2007-08-29
• Last Update Date: 2024-03-29

Provider Licenses

State	License ID	Taxonomies
AZ	46192	2085N0700X
HI	MD17657	2085R0202X
NE	27860	2085R0202X
KS	04-37164	2085R0202X
CO	53729	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology
No	2085N0700X	Allopathic & Osteopathic Physicians	Radiology	Neuroradiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NE	100257090-00	Medicaid
CO	43756786	Medicaid
OK	200546680A	Medicaid
CO	P01488708	Other	RAILROAD MEDICARE
NE	100262774-00	Medicaid
IA	1831383173	Medicaid
NE	100262777-00	Medicaid
MT	1831383173	Medicaid
KS	201098790A	Medicaid
NE	840597929-13	Medicaid
NE	840897126-00	Medicaid
NE	100262776-00	Medicaid
NE	100262778-00	Medicaid
UT	1831383173	Medicaid
NM	24807001	Medicaid
NE	100262775-00	Medicaid
WY	1831383173	Medicaid
NE	100262773-00	Medicaid
NM	24807001	Medicaid
OK	200546680A	Medicaid
NE	100262777-00	Medicaid
NE	840897126-00	Medicaid
NE	100262778-00	Medicaid
NE	NA1215090	Medicare PIN
KS	KA3249072	Medicare PIN
NE	100257090-00	Medicaid
NE	NA2517071	Medicare PIN
CO	348524YQ33	Medicare PIN