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Individual

DR. DANIEL GEOFFREY BOSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
597 S ENOTA DR NE, GAINESVILLE, GA 30501-2545
(770) 219-8102
(770) 219-7778
Mailing address
601 S ENOTA DR NE, SUITE Q, GAINESVILLE, GA 30501-2400
(770) 219-7826

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
36654
MO
207Q00000X
Family Medicine Physician
Primary
066761
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
247970015
MO
01
98641
AR BLUE SHIELD #
MO
Enumeration date
02/06/2007
Last updated
02/01/2021
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