Basic Information
| Provider Information | |||||||||
| NPI: | 1265646335 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OSTWANI | ||||||||
| FirstName: | WASEEM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3621 S STATE ST | ||||||||
| Address2: | 700 KMS PLACE | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349362047 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 E MEDICAL CENTER DRIVE | ||||||||
| Address2: | 12TH FLOOR C. S. MOTT CHILDRENS HOSPITAL RM 525 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481094280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347635302 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2007 | ||||||||
| LastUpdateDate: | 09/13/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 4301093791 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0203X | 4301093791 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.