Provider Demographics
NPI:1205856432
Name:OSKA, FADI (MD)
Entity type:Individual
Prefix:
First Name:FADI
Middle Name:
Last Name:OSKA
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 1:42755 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-3255
Mailing Address - Country:US
Mailing Address - Phone:586-323-0400
Mailing Address - Fax:586-323-3762
Practice Address - Street 1:42755 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3255
Practice Address - Country:US
Practice Address - Phone:586-323-0400
Practice Address - Fax:586-323-3762
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301061986207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI417954110Medicaid
MI0500824Medicare ID - Type Unspecified
MIG16458Medicare UPIN