MEDICARE: DR. BARRY MARVIN OSHEROWITZ MD

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	207RG0100X	Gastroenterology Physician	05818R	LA
2	207RG0100X	Gastroenterology Physician	MD10865	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023092673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY MARVIN OSHEROWITZ MD

Provider Business Mailing Address
First Line	:	1608 JIMMIE DAVIS HWY
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4559
Country	:	US
Telephone Number	:	318-747-2510
Fax Number	:	318-742-3727

Provider Business Practice Location Address
First Line	:	1608 JIMMIE DAVIS HWY
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4559
Country	:	US
Telephone Number	:	318-747-2510
Fax Number	:	318-742-3727

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

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/08/2007

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