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Individual
JAN OSTERSTOCK
Active
Individual
JAN OSTERSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
85-172584-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001563800
—
ID
05
—
002087103
—
NV
01
—
107004823101
IHC
UT
05
—
108839400
—
WY
01
—
14706
PEHP
UT
01
—
1502954
UMWA
UT
01
—
20114
DESERET MUTUAL
UT
01
—
2090168
UNITED HEALTHCARE
UT
01
—
53258
HEALTHY U
UT
05
—
822222
—
AZ
01
—
8597445
WORKERS COMP
UT
01
—
870545614OS1
EDUCATORS MUTUAL
UT
01
—
QM0000075886
ALTIUS
UT
01
—
TPRA07899
MOLINA
UT
Enumeration date
09/01/2006
Last updated
10/15/2012
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