Provider Demographics
NPI:1750045019
Name:OSMAN, IZDIHAR (RPH)
Entity type:Individual
Prefix:MRS
First Name:IZDIHAR
Middle Name:
Last Name:OSMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4890 OAK GROVE CT NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52411-6782
Mailing Address - Country:US
Mailing Address - Phone:202-725-3325
Mailing Address - Fax:
Practice Address - Street 1:3419 16TH AVE SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-2326
Practice Address - Country:US
Practice Address - Phone:319-396-3262
Practice Address - Fax:319-396-3267
Is Sole Proprietor?:No
Enumeration Date:2021-10-23
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist