Olson, Susan Jayne

Olson, Susan Jayne is an sole proprietor health care provider with primary practice located at 1297 Professional Dr Ste 104, Myrtle Beach SC 29577-5713. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Olson, Susan Jayne can be contacted via phone (843) 712-1854.

Contact Information

Primary practice address
1297 Professional Dr Ste 104 Myrtle Beach SC 29577-5713
Phone: (843) 712-1854
Fax: (843) 213-1681
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 26014 Wisconsin
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 29752 South Carolina
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 29752 South Carolina

Profile Details

NPI number 1205996303
LBN Legal business name Olson, Susan Jayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 11th, 2006
Last updated Jul 21st, 2022 - about 4 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 1205996303 NPPES
Wisconsin MEDICAID 30823300

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