Provider Demographics
NPI:1093789083
Name:OSTACHER, MICHAEL JOSHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSHUA
Last Name:OSTACHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS. GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:50 STANIFORD ST STE 580
Practice Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2540
Practice Address - Country:US
Practice Address - Phone:617-726-5258
Practice Address - Fax:617-726-6768
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2013-05-03
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Provider Licenses
StateLicense IDTaxonomies
MA726052084F0202X, 2084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA311 08 42Medicaid
E56603Medicare UPIN