Provider Demographics
NPI:1336152388
Name:OSBORNE, ROBERT MITCHELL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MITCHELL
Last Name:OSBORNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 NIMITZVIEW DR STE 210
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-4351
Mailing Address - Country:US
Mailing Address - Phone:513-624-3100
Mailing Address - Fax:513-232-8600
Practice Address - Street 1:1060 NIMITZVIEW DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2188
Practice Address - Country:US
Practice Address - Phone:513-624-3100
Practice Address - Fax:513-232-8600
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH35055841207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0735940Medicaid
OH0987464Medicaid
OH0735940Medicaid