Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 05818R | LA |
N | 207RG0100X | Gastroenterologist | MD10865 | DC |
NPI | 1023092673 |
---|---|
Provider Name | Dr. Barry Marvin Osherowitz |
First Address | Bossier City, LA 71112-4559 |
Second Address | Bossier City, LA 71112-4559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1323292 | (05) | LA |
B61092 | (02) |