Bostom, Andrew

Bostom, Andrew is an individual health care provider with primary practice located at 593 Eddy St Apc 9, Providence RI 02903-4923. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bostom, Andrew can be contacted via phone (401) 444-6460.

Contact Information

Primary practice address
593 Eddy St Apc 9 Providence RI 02903-4923
Phone: (401) 444-6460
Fax: (401) 444-2217
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD09437 Rhode Island

Profile Details

NPI number 1902850274
LBN Legal business name Bostom, Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Aug 5th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902850274 NPPES
Massachusetts MEDICAID 2100339
Massachusetts MEDICAID 9025311
Massachusetts Other P00024512

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