Organization
CALVIN JONATHAN BOSMAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CALVIN JONATHAN BOSMAN MD (PSYCHIATRIST)
(843) 906-7728
Entity
Organization
Contact information
Practice address
4 CARRIAGE LN, SUITE 300-C, CHARLESTON, SC 29407-6065
(843) 906-7728
Mailing address
26 MOORE DR, CHARLESTON, SC 29407-7230
(843) 906-7728
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28183
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5904
—
SC
Enumeration date
03/29/2012
Last updated
11/15/2012
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