Individual
MATTHEW S BOSNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
575 PINE DRIVE, STE. GENEVIEVE, MO 63670
(573) 883-7474
(573) 883-7426
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R8E35
MO
207RC0000X
Cardiovascular Disease Physician
Primary
R8E35
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110155660
RR MEDICARE PIN
MO
05
—
202582136
—
MO
Enumeration date
01/18/2006
Last updated
02/17/2021
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