Individual
DR. LARA MARIEL OSETINSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4069 LAKE DR SE STE 315, GRAND RAPIDS, MI 49546-8816
(616) 267-7758
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
1609283936
MN
207Y00000X
Otolaryngology Physician
Primary
4301517179
MI
207Y00000X
Otolaryngology Physician
Primary
52806
KY
207Y00000X
Otolaryngology Physician
59516
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/18/2014
Last updated
07/07/2026
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