Mikkilineni, Bose S.

Mikkilineni, Bose S. is an sole proprietor health care provider with primary practice located at 419 Carriage Dr , Beckley WV 25801-2805. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mikkilineni, Bose S. can be contacted via phone (304) 253-8416.

Contact Information

Primary practice address
419 Carriage Dr Beckley WV 25801-2805
Phone: (304) 253-8416
Fax: (866) 461-4726
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 12282 West Virginia

Profile Details

NPI number 1407840549
LBN Legal business name Mikkilineni, Bose S.
Credentials M.D. FACS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 5th, 2005
Last updated Jun 4th, 2013 - about 11 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 1407840549 NPPES
West Virginia Other 001720379 BCBS
West Virginia Other 020002556 BCBS
West Virginia Other 151389100 BCBS
West Virginia Other 550631859 BCBS
West Virginia Other 68790 BCBS
West Virginia Other 231835 BCBS
West Virginia Other 49236 BCBS
West Virginia MEDICAID 0128502000 BCBS
West Virginia Other 151389100 BCBS
West Virginia Other 6441144 BCBS

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