Individual
PRABIR K BOSE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
223 EASTERN BLVD, BALTIMORE, MD 21221-6906
(410) 284-2407
(410) 284-2311
Mailing address
PO BOX 64075, BALTIMORE, MD 21264-4075
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D0014803
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KG65 / 304360
BC / BS OF MD
MD
01
—
S186 / 0078
BLUECHOICE
MD
Enumeration date
06/12/2006
Last updated
07/08/2007
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