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General NPI Number Information
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NPI Number | 1467415901
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Entity Type | Individual
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Provider Name | EDWARD STEPHEN OSTROWSKI MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 1502 NORTH THORNTON AVENUE
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City | DALTON
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State | GA
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Zip | 30720-3064
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Country | US
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Telephone | 706-278-9729
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Fax | 706-226-9378
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Provider Business Mailing Address
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Address Line | P.O. BOX 1207
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City | DALTON
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State | GA
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Zip | 30722-1207
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Country | US
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Telephone | 706-278-9729
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Fax | 706-226-9378
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 73603
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License Number State | GA
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