Individual
DR. GRETCHEN BOSACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7000
Mailing address
400 ROBERT ST N, SAINT PAUL, MN 55101-2098
(651) 665-3221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48016
MN
Other
Enumeration date
03/22/2006
Last updated
06/22/2011
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