Individual
DR. BOSE MANYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 E OAK AVE, JONESBORO, AR 72401-4163
(870) 268-4404
(870) 268-4478
Mailing address
201 E OAK AVE, JONESBORO, AR 72401-4163
(870) 268-4404
(870) 268-4478
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E-11902
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231587001
—
AR
Enumeration date
04/19/2006
Last updated
03/16/2020
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