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Individual

DR. ERIC WILLIAM BOOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6701 ROCKSIDE RD, STE 260, INDEPENDENCE, OH 44131-2351
(216) 369-2525
(216) 369-2531
Mailing address
6701 ROCKSIDE RD, STE 260, INDEPENDENCE, OH 44131-2351
(216) 369-2525
(216) 369-2531

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35081506B
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000489324
ANTHEM
OH
05
2332952
OH
01
350411
WELLCARE
OH
01
T81506
SUMMACARE
OH
Enumeration date
05/23/2005
Last updated
07/17/2009
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