Provider Demographics
NPI:1912068909
Name:OSMAN CLINIC & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:OSMAN CLINIC & ASSOCIATES, P.C.
Other - Org Name:OSMAN CLINIC & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:VAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-876-3699
Mailing Address - Street 1:3307 W 96TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1106
Mailing Address - Country:US
Mailing Address - Phone:317-876-3699
Mailing Address - Fax:317-876-3600
Practice Address - Street 1:3307 W 96TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1106
Practice Address - Country:US
Practice Address - Phone:317-876-3699
Practice Address - Fax:317-876-3600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054084A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN218710Medicare PIN