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Individual
MR. ROBERT DEAN BOSTIC
Active
Individual
MR. ROBERT DEAN BOSTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102627
NC
363A00000X
Physician Assistant
545
SC
363A00000X
Physician Assistant
PA9110455
FL
363AM0700X
Medical Physician Assistant
102627
NC
363AM0700X
Medical Physician Assistant
A545
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076PA
—
SC
01
—
NN2123A
MEDICARE PTAN
NC
01
—
P02056923
RR MEDICARE
NC
Enumeration date
06/17/2006
Last updated
06/18/2024
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