Healthcare Provider Details

I. General information

NPI: 1063411445
Provider Name (Legal Business Name): LAWRENCE STEVEN OSHER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 EUCLID AVE
CLEVELAND OH
44103
US

IV. Provider business mailing address

2171 CEDARVIEW DR
BEACHWOOD OH
44122-1220
US

V. Phone/Fax

Practice location:
  • Phone: 216-231-5612
  • Fax:
Mailing address:
  • Phone: 216-382-0282
  • Fax: 216-691-1640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2117
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: