Individual
NICOLE M. BOSSENBROEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6225 PRAIRIE ST, NORTON SHORES, MI 49444-7831
(231) 798-9500
(231) 798-9533
Mailing address
6225 PRAIRIE ST, NORTON SHORES, MI 49444-7831
(231) 798-9500
(231) 798-9533
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
046274
CT
207ND0900X
Dermatopathology Physician
4301079716
MI
Other
Enumeration date
07/07/2006
Last updated
02/16/2010
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