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General NPI Number Information
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NPI Number | 1730749268
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Entity Type | Individual
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Provider Name | OSAGIE ROBERT USEN MD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 41 FORT BAYARD RD
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City | SANTA CLARA
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State | NM
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Zip | 88026-5202
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Country | US
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Telephone | 915-701-6792
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Fax | 575-537-8897
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Provider Business Mailing Address
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Address Line | 4801 ALBERTA AVE
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City | EL PASO
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State | TX
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Zip | 79905-2707
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Country | US
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Telephone |
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD2023-1274
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License Number State | NM
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