MEDICARE: DR. JOSEPH ERIC OSHEROFF M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D0060028	MD

General Provider Information

NPI Number	:	1871588707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH ERIC OSHEROFF M.D.

Provider Business Mailing Address
First Line	:	15001 SHADY GROVE RD
Second Line	:	SUITE 340
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-6352
Country	:	US
Telephone Number	:	301-340-1188
Fax Number	:	301-340-6478

Provider Business Practice Location Address
First Line	:	10630 LITTLE PATUXENT PKWY
Second Line	:	SUITE 305
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3264
Country	:	US
Telephone Number	:	410-997-6999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	07/08/2007

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