Individual
BRONSON BOOSALIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7500 MERCY RD, OMAHA, NE 68124-2319
(402) 559-6802
Mailing address
7500 MERCY RD, ATTN: EMERGENCY DEPARTMENT, OMAHA, NE 68124-2319
(402) 398-6060
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28607
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28607
STATE OF NEBRASKA
NE
Enumeration date
06/06/2013
Last updated
08/06/2016
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