Provider Demographics
NPI:1063411445
Name:OSHER, LAWRENCE STEVEN (DPM)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:STEVEN
Last Name:OSHER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 CEDARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1220
Mailing Address - Country:US
Mailing Address - Phone:216-382-0282
Mailing Address - Fax:216-691-1640
Practice Address - Street 1:4415 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103
Practice Address - Country:US
Practice Address - Phone:216-231-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2117213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCH5179OtherRR MEDICARE GROUP
OH0529944Medicare PIN
OHCH5179OtherRR MEDICARE GROUP
OH4310000001Medicare NSC
OHT80553Medicare UPIN