Individual
DR. MARC WAYNE BOSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
413 ALLUMBAUGH ST, SUITE 101, BOISE, ID 83704-9212
(208) 323-1125
Mailing address
413 N ALLUMBAUGH ST STE 101, BOISE, ID 83704-9219
(208) 954-5594
(208) 954-5598
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M7712
ID
Other
Enumeration date
07/06/2006
Last updated
04/16/2021
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