Individual
CARA BOSCO MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 631-0002
Mailing address
4266 WOODLANDS LN, ORCHARD LAKE, MI 48323-1675
(248) 683-4266
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06328
NC
363A00000X
Physician Assistant
3979
WI
363A00000X
Physician Assistant
5601006966
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083091185
—
NC
05
—
2596PA
—
SC
Enumeration date
04/28/2015
Last updated
09/13/2023
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