Individual
DR. GARY DOUGLAS BOZEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
806 W BROADWAY, FULTON, NY 13069-1533
(315) 297-4700
(315) 218-5898
Mailing address
1226 E WATER ST, SYRACUSE, NY 13210-1155
(315) 478-4185
(315) 478-0840
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
272579
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153372
—
SC
Enumeration date
02/28/2006
Last updated
02/21/2014
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