Provider Demographics
NPI:1467447649
Name:OSTERMANN, MARY F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:OSTERMANN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:705 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-3053
Mailing Address - Country:US
Mailing Address - Phone:920-885-6090
Mailing Address - Fax:920-885-6092
Practice Address - Street 1:705 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-3053
Practice Address - Country:US
Practice Address - Phone:920-885-6090
Practice Address - Fax:920-885-6092
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2014-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI36516207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32118600Medicaid
WI32118600Medicaid