Organization
JOHN L BOSSIAN
Active
Other names
Main Street Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LEON BOSSIAN II DO (PHYSICIAN)
(401) 789-1600
Entity
Organization
Contact information
Practice address
66 MAIN ST, WAKEFIELD, RI 02879-3555
(401) 789-1600
Mailing address
66 MAIN ST, WAKEFIELD, RI 02879-3555
(401) 789-1600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO0391
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MS46923
OTHER
RI
05
—
MS46923
—
RI
Enumeration date
04/06/2007
Last updated
06/17/2008
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