Provider Demographics
NPI:1316922271
Name:OSHEA, MARY D (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:D
Last Name:OSHEA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3270 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-2901
Mailing Address - Country:US
Mailing Address - Phone:248-816-2558
Mailing Address - Fax:248-816-2801
Practice Address - Street 1:3270 W BIG BEAVER RD
Practice Address - Street 2:SUITE 400
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2901
Practice Address - Country:US
Practice Address - Phone:248-816-2558
Practice Address - Fax:248-816-2801
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2009-10-26
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Provider Licenses
StateLicense IDTaxonomies
MI4301056871208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3110660Medicaid
MI3110660Medicaid
F65486Medicare UPIN