Individual
DR. ANDREW WADE OSBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(805) 569-2964
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
16434
ND
2085R0202X
Diagnostic Radiology Physician
G75889
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G758890
BS
CA
05
—
00G758890
—
CA
01
—
P0030291
RR MC
CA
Enumeration date
06/23/2005
Last updated
10/31/2024
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