Olsen, Kenneth David

Olsen, Kenneth David is an individual health care provider with primary practice located at 2925 Chicago Ave , Minneapolis MN 55407-1321. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Olsen, Kenneth David can be contacted via phone (612) 863-4000.

Contact Information

Primary practice address
2925 Chicago Ave Minneapolis MN 55407-1321
Phone: (612) 863-4000
Fax: (763) 236-3026
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 1033179429 Minnesota
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 37478 Minnesota

Profile Details

NPI number 1033179429
LBN Legal business name Olsen, Kenneth David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Nov 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033179429 NPPES
Minnesota MEDICAID 409525100

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