Bosbous, Mark Walter
Bosbous, Mark Walter is an individual health care provider with primary practice located at 9200 W Wisconsin Avenue Plastic Surgery, Milwaukee WI 53226-3522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Bosbous, Mark Walter can be contacted via phone (414) 805-3666.Contact Information
Primary practice address
9200 W Wisconsin Avenue Plastic Surgery
Milwaukee WI 53226-3522
Phone: (414) 805-3666
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 49468-020 | Wisconsin |
Profile Details
| NPI number | 1033203906 |
|---|---|
| LBN Legal business name | Bosbous, Mark Walter |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Nov 27th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033203906 | NPPES |
| Wisconsin | MEDICAID | 1033203906 |
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