Provider Demographics
NPI:1265553523
Name:OSHER, SANFORD S (MD)
Entity type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:S
Last Name:OSHER
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 1:10495 MONTGOMERY ROAD
Mailing Address - Street 2:STE 14
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242
Mailing Address - Country:US
Mailing Address - Phone:513-984-9878
Mailing Address - Fax:513-984-9870
Practice Address - Street 1:10495 MONTGOMERY RD
Practice Address - Street 2:STE 14
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-984-9878
Practice Address - Fax:513-984-9870
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35055036207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0705615Medicaid
OH6021101Medicare ID - Type Unspecified
A17720Medicare UPIN