Osama Elsabagh MD PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301086876 Issued in MI

Legal business name

OSAMA ELSABAGH MD PLLC

Practice address

55 N Pond Dr Ste 2
Walled Lake, MI 48390-3080

Phone

(248) 624-6633

Fax

(248) 624-0748

NPI assigned

Mar 22, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Osama Elsabagh, MD

Title

Owner

Phone

(989) 992-9408

Specialties & licenses 1

Addresses

Other names 1

• Summit Care Pediatrics Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1437653532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 N POND DR STE 2",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903080",
            "telephone_number": "248-624-6633",
            "fax_number": "248-624-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N POND DR STE 2",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903080",
            "telephone_number": "248-624-6633",
            "fax_number": "248-624-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSAMA ELSABAGH MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "ELSABAGH",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-992-9408",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301086876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Care Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Walled Lake, MI
• Providers in Walled Lake, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.