Provider Demographics
NPI:1720347339
Name:OSMANSKI, BRANDON MATTHEW (DO)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:MATTHEW
Last Name:OSMANSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4967 CROOKS RD
Mailing Address - Street 2:STE 130
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-5801
Mailing Address - Country:US
Mailing Address - Phone:248-952-1601
Mailing Address - Fax:248-952-1614
Practice Address - Street 1:11885 E 12 MILE RD
Practice Address - Street 2:STE. 300A
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3474
Practice Address - Country:US
Practice Address - Phone:586-582-6630
Practice Address - Fax:586-582-6631
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2015-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101019775207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine