Individual
ANDREW BOSTOM
Active
Individual
ANDREW BOSTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD09437
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100339
—
MA
05
—
9025311
—
RI
01
—
P00024512
RAILROAD MEDICARE
RI
Enumeration date
05/20/2006
Last updated
08/05/2008
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