Provider Demographics
NPI:1386910073
Name:OSMAN, MAGDY A (MD)
Entity type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:A
Last Name:OSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:574 PRAIRIE CENTER DR
Mailing Address - Street 2:#135-276
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7930
Mailing Address - Country:US
Mailing Address - Phone:917-669-6304
Mailing Address - Fax:
Practice Address - Street 1:75 HAIL KNOB RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3434
Practice Address - Country:US
Practice Address - Phone:606-678-9617
Practice Address - Fax:606-678-9619
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY32902207T00000X
VT0101055449207T00000X
UT291496-1205207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY32902OtherKY LICENSE