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Individual

MARK P VANDEN BOSCH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 NORTH ST, BERKSHIRE MEDICAL CENTER, PITTSFIELD, MA 01201-4132
(413) 447-2555
(413) 443-7039
Mailing address
100 NORTH ST, STE 413, PITTSFIELD, MA 01201-5109
(413) 447-2555
(413) 443-7039

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
214246
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0180807
MA
Enumeration date
08/24/2005
Last updated
07/08/2007
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