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Individual
MICHAEL A. BOSSAK
Active
Individual
MICHAEL A. BOSSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
066457
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003111162A
—
GA
01
—
01457468
AMERIGROUP
GA
01
—
624791
WELLCARE
GA
05
—
GA1236
—
SC
01
—
P00955092
RAILROAD MEDICARE
GA
Enumeration date
06/11/2008
Last updated
08/07/2018
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