Individual
DR. JEFFERY BOSSENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
17200 SILVER PKWY, FENTON, MI 48430-4437
(810) 714-9660
(810) 714-9661
Mailing address
17200 SILVER PKWY, FENTON, MI 48430-3423
(810) 714-9660
(810) 714-9661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012104
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3278563
—
MI
Enumeration date
12/01/2006
Last updated
11/29/2018
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