Individual
DOUGLAS P BOSACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
RR 2 BOX 171, LEWISBURG, WV 24901-9318
(304) 345-9023
(304) 645-9025
Mailing address
PO BOX 790, WHITE SULPHUR SPRINGS, WV 24986-0790
(304) 536-5030
(304) 536-5031
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
21789
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001625
—
WV
Enumeration date
06/13/2005
Last updated
07/09/2007
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