Healthcare Provider Details

I. General information

NPI: 1982232005
Provider Name (Legal Business Name): AUGUSTINE OSULA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE
BALTIMORE MD
21215-5270
US

IV. Provider business mailing address

2435 W BELVEDERE AVE STE 33 SUITE #33
BALTIMORE MD
21215-5224
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-5530
  • Fax:
Mailing address:
  • Phone: 410-601-5530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number30908
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: