Provider Demographics
NPI:1255849709
Name:OSMAN MEDICAL CARE, PLLC
Entity type:Organization
Organization Name:OSMAN MEDICAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCICIAN
Authorized Official - Prefix:
Authorized Official - First Name:OSMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-752-4516
Mailing Address - Street 1:500 FOWLER AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-3326
Mailing Address - Country:US
Mailing Address - Phone:570-752-4516
Mailing Address - Fax:570-752-4518
Practice Address - Street 1:500 FOWLER AVE STE 203
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-3326
Practice Address - Country:US
Practice Address - Phone:570-752-4516
Practice Address - Fax:570-752-4518
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSMAN MEDICAL CARE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-18
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD440985207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty