Individual
THOMAS MICHAEL BOUSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1133 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-2402
(757) 496-2050
(757) 689-4357
Mailing address
1133 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-2402
(757) 496-2050
(757) 689-4357
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011001605
VA
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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