Provider Demographics
NPI:1871543009
Name:OLSON, BEATRIZ R (MD)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:R
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:850 STRAITS TPKE
Mailing Address - Street 2:STE 204
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762
Mailing Address - Country:US
Mailing Address - Phone:203-758-2594
Mailing Address - Fax:203-758-2708
Practice Address - Street 1:850 STRAITS TPKE
Practice Address - Street 2:STE 204
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762
Practice Address - Country:US
Practice Address - Phone:203-758-2594
Practice Address - Fax:203-758-2708
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT034750207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010034750CT01OtherBCBS
743992OtherCT CARE
P621103OtherOFFORD
743992OtherCT CARE