Individual
GRANT G BOSCHULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 802-2100
(920) 802-1500
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
61755
WI
208M00000X
Hospitalist Physician
Primary
61755
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100035048
—
WI
Enumeration date
03/28/2012
Last updated
05/04/2026
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