Individual
JOHN A. BOSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
732 HARRISON AVE, PRESTON BUILDING FL 3, BOSTON, MA 02118-2309
(617) 638-7490
(617) 414-8742
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1019765
MA
207RC0000X
Cardiovascular Disease Physician
Primary
1019765
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110176921A
—
MA
05
—
3148503
—
NH
Enumeration date
04/19/2017
Last updated
04/13/2026
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