Provider Demographics
NPI:1659831980
Name:OSILLA, EVA V (DO)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:V
Last Name:OSILLA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:804 SERVICE RD STE A109B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-353-2562
Mailing Address - Fax:517-353-2563
Practice Address - Street 1:804 SERVICE RD STE A225
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7015
Practice Address - Country:US
Practice Address - Phone:517-353-2562
Practice Address - Fax:517-353-2563
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2023-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101026990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine