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Individual

BARBARA L. BOSCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
77 W FOREST AVE, SUITE 304, FLAGSTAFF, AZ 86001-1479
(928) 214-3600
(928) 214-3601
Mailing address
77 W FOREST AVE, SUITE 304, FLAGSTAFF, AZ 86001-1479
(928) 214-3600
(928) 214-3601

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32739
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0753850
BCBS
AZ
01
2Z1003
HEALTH NET
AZ
01
5217269
CIGNA
AZ
01
5592602
AETNA
AZ
05
856495
AZ
Enumeration date
08/22/2005
Last updated
07/22/2011
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