Individual
ANNA BOSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 629-8000
(502) 629-6129
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2020017726
MO
207P00000X
Emergency Medicine Physician
Primary
57861
KY
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7281859
UNITED HEALTHCARE
—
Enumeration date
04/14/2018
Last updated
05/30/2024
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