Provider Demographics
NPI:1093276669
Name:OLSON, ERIC MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:MATTHEW
Last Name:OLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6729 VAN HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6531
Mailing Address - Country:US
Mailing Address - Phone:405-250-9091
Mailing Address - Fax:
Practice Address - Street 1:23 SUNNYBROOK RD STE 220
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1855
Practice Address - Country:US
Practice Address - Phone:287-391-9350
Practice Address - Fax:919-235-1388
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2025-00143207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program