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Individual

ABE GOLDSWORTHY OSBOURNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
4415 EUCLID AVE, CLEVELAND, OH 44103-3759
(216) 231-5612
(216) 721-5534
Mailing address
23780 HALBURTON RD, BEACHWOOD, OH 44122-7603
(216) 765-1559
(216) 765-1559

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002695
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2740458
OH
01
CH5179
RR MEDICARE GROUP
OH
01
P00435156
RR MEDICARE #
OH
Enumeration date
10/03/2006
Last updated
02/22/2008
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