Individual provider · NPI-1

Dr. Pradeep Bose, M.D.

Family Medicine, Adolescent Medicine · Richmond, KY

NPI number1841337433
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1841337433
Entity type
Individual (NPI-1)
Name
Dr. Pradeep Bose
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Jan 31, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207QA0000X Family Medicine, Adolescent Medicine25666KYYes

Practice location

521 Lancaster Ave
Richmond, KY 40475-3100

Phone 859-622-1761 · Fax 859-622-1767

Mailing address

2364 Abbeywood Rd
Lexington, KY 40515-1272

Phone 859-622-1761 · Fax 859-622-1767

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