Individual
DOROTHY A OSTERHAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2000
(859) 301-2073
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-2018
(859) 301-2073
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
30665
KY
207ZP0101X
Anatomic Pathology Physician
01055834A
IN
207ZP0101X
Anatomic Pathology Physician
Primary
30665
KY
207ZP0101X
Anatomic Pathology Physician
35067013
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35067013
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181897
—
OH
05
—
200214200B
—
IN
01
—
220022767
RAILROAD MEDICARE
—
05
—
64306657
—
KY
Enumeration date
10/27/2005
Last updated
09/20/2018
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