Provider Demographics
NPI:1891775334
Name:OSTERGAARD, CARY ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:ALAN
Last Name:OSTERGAARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 N MCKENZIE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-4703
Mailing Address - Country:US
Mailing Address - Phone:251-949-3479
Mailing Address - Fax:251-949-3434
Practice Address - Street 1:1851 N MCKENZIE ST STE 101
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-4703
Practice Address - Country:US
Practice Address - Phone:251-424-1232
Practice Address - Fax:251-949-1954
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN