Individual
JERALD P BOSEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
121 S OREM BLVD STE 103, OREM, UT 84058-3006
(801) 225-4911
(801) 225-4854
Mailing address
121 S OREM BLVD STE 103, OREM, UT 84058-3006
(801) 225-4911
(801) 225-4854
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
48108
CO
207RN0300X
Nephrology Physician
48849
MN
207RN0300X
Nephrology Physician
Primary
5929764-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055435000
—
MN
05
—
29025354
—
CO
05
—
3007868
—
UT
Enumeration date
08/11/2006
Last updated
05/02/2024
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