PERRY J OLSON (NPI# 1104847847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104847847 |
| Entity Type | Individual |
| Full Name | PERRY J OLSON |
| Credential | P.A.-C. |
| Practice Address |
20400 W Warren Ave Detroit MI 48228-3242 |
| Mailing Address |
23161 Britner Ct Bingham Farms MI 48025-4707 |
| Practice Telephone | 3132710500 |
| Practice Fax Number | 3132719319 |
| Mailing Telephone | 2489888227 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-01-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
364544473 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RAILROAD MEDICARE | P00219893 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285017368 | Perry Olson | Behavioral Analyst | 50 Emerson Rd, Milford, NH 03055-3516 | 2015-07-07 |
| Street Address |
20400 W WARREN AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48228-3242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033106331 | Amy G. Connolly | Physician Assistant | 20400 W Warren Ave, Detroit, MI 48228-3242 | 2005-10-01 |
| 1124390331 | Stephanie Marie Workman | Registered Nurse | 20400 W Warren Ave, Detroit, MI 48228-3242 | 2012-02-02 |
| 1366659807 | Stout Family Medicine PC | Clinic/Center | 20400 W Warren Ave, Detroit, MI 48228-3242 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932737210 | West Park Pharmacy LLC | Pharmacy | 16240 W Warren Ave, Detroit, MI 48228 | 2020-03-31 |
| 1316433329 | 4 Ur Recovery Therapy, LLC | Clinic/Center | 19201 Warren St, Detroit, MI 48228 | 2018-07-03 |
| 1003309063 | Marquita Outlaw | Registered Nurse | 8290 Coyle St, Detroit, MI 48228 | 2018-06-13 |
| 1043746548 | Am-pm Transportation Services LLC | Private Vehicle | 18640 Joy Road, Detroit, MI 48228 | 2017-05-04 |
| 1770023491 | Goodcompany Aop Inc | In Home Supportive Care | 8946 Prest St, Detroit, MI 48228 | 2017-02-28 |
| 1881049260 | Christine Jackson | Social Worker | 9115 Warwick, Detroit, MI 48228 | 2016-05-04 |
| 1790157774 | Shakail Bronta Hill | Adult Companion | 7729 Clayburn, Detroit, MI 48228 | 2015-10-29 |
| 1275904583 | Denarol Cunningham | Contractor | 7248 Vaughan, Detroit, MI 48228 | 2015-10-13 |
| 1023493210 | Larry Foster | Technician, Other | 9334 Memorial, Detroit, MI 48228 | 2015-07-29 |
| 1093126872 | Reza Hafezi | Chiropractor | 17600 W. Warren Ave., Detroit, MI 48228 | 2014-05-14 |
| Find all providers in zip 48228 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831340355 | Antonia L Navarro | Physician Assistant | University Physician Group Oncology, 4100 John R, Detroit, MI 48201-2013 | 2008-10-02 |
| 1104974443 | Amy B Oatfield | Physician Assistant | Henry Ford Hospital Trauma and Critical Care Cfp-1, 2799 West Grand Blvd, Detroit, MI 48202 | 2007-01-05 |
| 1295750677 | Ingrid Dominic Mitchell | Physician Assistant | 18254 Livernois Ave Ste 1, Detroit, MI 48221-4214 | 2006-07-13 |
| 1952397291 | Kelly Michelle Brown | Physician Assistant | 22151 Moross Rd Ste 320, Maternal Fetal Medicine St John Hospital & Medical Cen, Detroit, MI 48236-2196 | 2005-09-22 |
| 1467067975 | Jerrica Clemens | Physician Assistant | 4100 Woodward Ave, Detroit, MI 48201-2173 | 2020-09-11 |
| 1679195176 | Shane Michael Dignan | Physician Assistant | 259 Mack Ave, Detroit, MI 48201-2427 | 2020-05-07 |
| 1174154843 | Weston Alexander Davis | Physician Assistant | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-01-30 |
| 1689225443 | Alaa Eddin Tahboub | Physician Assistant | 4771 Michigan Ave, Detroit, MI 48210-9718 | 2019-09-24 |
| 1609338367 | Aanchal Bhojwani | Physician Assistant | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2019-04-02 |
| 1952883068 | Jeremy Lynn Herzberg | Physician Assistant | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2018-09-05 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.