Individual
DR. MARCUS BOSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-9447
(802) 847-9644
Mailing address
460 MARTEL LN, ST GEORGE, VT 05495-7087
(802) 878-0917
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
042-0010348
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008503
—
VT
Enumeration date
07/24/2006
Last updated
07/08/2007
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