Organization
BRUCE E BOSSE MDPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ERIC BOSSE M.D. (PHYSICIAN)
(770) 663-4649
Entity
Organization
Contact information
Practice address
2500 HOSPITAL BLVD, SUITE 440, ROSWELL, GA 30076-4907
(770) 663-4649
(770) 663-3930
Mailing address
2500 HOSPITAL BLVD, SUITE 440, ROSWELL, GA 30076-4907
(770) 663-4649
(770) 663-3930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
034503
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000465132B
—
GA
01
—
13BDBWB
MEDICARE PROVIDER NUMBER
GA
Enumeration date
03/31/2011
Last updated
03/31/2011
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