Individual
THOMAS A BOSTAPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
1602 FORD AVE, CUMBERLAND, MD 21502-4612
(301) 759-4544
(301) 723-4446
Mailing address
1602 FORD AVE, CUMBERLAND, MD 21502-4612
(301) 759-4544
(301) 723-4446
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R087737
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342102300
—
MD
01
—
754LA787
MEDICARE
—
Enumeration date
05/22/2006
Last updated
02/19/2016
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