MEDICARE: SID OSBORN

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1972434892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SID OSBORN

Provider Business Mailing Address
First Line	:	1370 SPRINGWOOD LN
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-2607
Country	:	US
Telephone Number	:	248-761-5034
Fax Number	:	248-761-5034

Provider Business Practice Location Address
First Line	:	3875 BAY RD STE 4S
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-2423
Country	:	US
Telephone Number	:	989-583-0000
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ SID OSBORN ” Practice Location

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