Individual
DR. DAVID BRUCE BOSSCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
336 S RIVER AVE, HOLLAND, MI 49423-3326
(616) 394-3788
(616) 394-3796
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02533
KY
207Q00000X
Family Medicine Physician
1238
TN
207Q00000X
Family Medicine Physician
Primary
510100847
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0850310164
BCBSM
MI
01
—
115223241
MI MEDICAID
MI
05
—
64025331
—
KY
01
—
DB008747
STATE LICENSE
MI
01
—
P00443946
RAILROAD MEDICARE
MI
Enumeration date
05/24/2005
Last updated
10/01/2021
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