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ELDON W OLSON MD

Physicians Radiology Body Imaging

Provider NPI: 1639159601

Provider Information:
 ELDON W OLSON MD
Gender: M
Not Sole Proprietor

Practice Location:
620 W EDISON RD STE 110 MISHAWAKA, IN 46545-2784 US
Tel: 574-258-1100  Fax: 574-258-1101

Business Mailing Address:
620 W EDISON RD STE 110 MISHAWAKA, IN 46545-2784 US
Tel: 574-258-1100  Fax: 574-258-1101

NPI Information:
NPI: 1639159601
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N2085B0100XPhysicians
Radiology
Body Imaging
IN01053117A
N2085N0700XPhysicians
Radiology
IN01053117A
N2085N0904XPhysicians
Radiology
IN01053117A
N2085P0229XPhysicians
Radiology
IN01053117A
Y2085R0202XPhysicians
Radiology
IN01053117A
N2085R0203XPhysicians
Radiology
IN01053117A
N2085R0204XPhysicians
Radiology
IN01053117A
N2085U0001XPhysicians
Radiology
IN01053117A

Other Provider Identifiers:

IssuerNumberStateType
100322280IN05



American Medical Association 2012 taxonomy code information

Code: 2085R0202X

Type:

Classification:



Definition:



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