Individual
DR. CHRISTOPHER J. BOSARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5149 N 9TH AVE STE 120, PENSACOLA, FL 32504-8734
(850) 479-1805
(850) 479-1829
Mailing address
PO BOX 11982, PENSACOLA, FL 32524-1982
(850) 479-1805
(850) 479-1829
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME073699
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME073699
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009936285
ALABAMA EDS MEDICAID
AL
05
—
268360100
—
FL
01
—
42272
BCBS
FL
01
—
68675
BCBS OF ALABAMA
AL
01
—
P00137401
RR MEDICARE
FL
Enumeration date
05/02/2006
Last updated
11/12/2019
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