Provider Demographics
NPI:1265539324
Name:OSTROSKI, ANGELA M (DPM)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:OSTROSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR LBBY J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5333 MCAULEY DR RM 4012
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1099
Practice Address - Country:US
Practice Address - Phone:734-572-1141
Practice Address - Fax:734-572-1142
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001994213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0994547OtherHEALTH PLUS OF MICHIGAN
MI4409614Medicaid
MI5251076OtherBLUE CARE NETWORK
MI5251076OtherMEDICARE PLUS BLUE
MI1014624OtherMCLAREN HEALTH PLAN
MI4155400001OtherADMINISTAR FEDERAL
MI5251076OtherBLUE CARE NETWORK ADVANTA
MIAR001994OtherSTATE LICENSE NUMBER
MI1014624OtherMCLAREN HEALTH ADVANTAGE
MIP00291929OtherPALMETTO GBA RAILROAD MED
MI5251076OtherBLUE CROSS PIN NUMBER
MI0999853OtherHEALTH PLUS OF MICHIGAN
MI4722167Medicaid
MI5251076OtherBLUE CARE NETWORK ADVANTA
MI0P15770Medicare ID - Type Unspecified