Provider Demographics
NPI:1467421693
Name:OSMER, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:OSMER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:804 SERVICE RD
Mailing Address - Street 2:A201
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:4660 SOUTH HAGADORN ROAD
Practice Address - Street 2:SUITE 600
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-267-2460
Practice Address - Fax:517-267-2462
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
MI4301044284208600000X
WI53946208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI711290156OtherMEDICARE PTAN
MI1467421693Medicaid
WI450030760OtherMEDICARE PTAN
0203910771OtherBCBS
MI1467421693Medicaid
0203910771OtherBCBS
B46728Medicare UPIN
WI450030760OtherMEDICARE PTAN