Provider Demographics
NPI:1760686257
Name:OSGOOD, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:OSGOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:520 UPPER CHESAPEAKE DR STE 306
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4375
Mailing Address - Country:US
Mailing Address - Phone:410-879-2006
Mailing Address - Fax:410-879-0248
Practice Address - Street 1:520 UPPER CHESAPEAKE DR STE 306
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4375
Practice Address - Country:US
Practice Address - Phone:410-879-2006
Practice Address - Fax:410-879-0248
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD829492086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program