Individual
MICHAEL OSMUNDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-3849
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
49520
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10064445
AMERIGROUP
GA
01
—
196100
BLUE CROSS BLUE SHIELD
GA
01
—
963738113A
PEACH STATE HEALTH PLAN
GA
05
—
963738113A
—
GA
05
—
G49520
—
SC
01
—
N362158
WELLCARE
GA
Enumeration date
05/18/2006
Last updated
03/07/2023
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