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Individual

DR. THANGAMADHAN BOSEMANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MBBS

Contact information

Practice address
600 N WOLFE ST, NELSON B173, BALTIMORE, MD 21287-0005
(410) 614-3772
Mailing address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0300

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
D74513
MD
2085R0202X
Diagnostic Radiology Physician
Primary
Q7533
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
057642500
MD
Enumeration date
07/19/2010
Last updated
06/14/2016
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