Marc Bostick MD Chartered
Psychiatry & Neurology, Psychiatry in Boise, ID. Organization (NPI-2).
NPI number1508034802
StatusActive
Last updated in NPPESApr 21, 2021
Details
- NPI
- 1508034802
- Entity type
- Organization (NPI-2)
- Legal business name
- Marc Bostick MD Chartered
- Organization subpart
- No
- Enumeration date
- Feb 20, 2008
- Certification date
- Apr 21, 2021
- Last updated
- Apr 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | M7712 | ID | Yes |
Practice location
413 N Allumbaugh StSte 101
Boise, ID 83704-9219
Phone 208-323-1125 · Fax 208-323-9604
Mailing address
413 N Allumbaugh StSte 101
Boise, ID 83704-9219
Phone 208-323-1125 · Fax 208-323-9604
Authorized official
Cheri Peterson
Credentialer
2089545594
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