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NPI Code Detail

MEDICARE: DR. LOREN D BOSMANS MD

MEDICARE: DR. LOREN D BOSMANS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35347MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598742793
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOREN D BOSMANS MD
Provider Business Mailing Address
First Line : 2800 CHICAGO AVE. SOUTH
Second Line : STE. 250
City : MINNEAPOLIS
State : MN
Zip : 55407-1321
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2800 CHICAGO AVE
Second Line : STE. 250
City : MINNEAPOLIS
State : MN
Zip : 55407-1318
Country : US
Telephone Number : 612-863-4096
Fax Number : 612-863-2132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 12/02/2011

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Directions to “ DR. LOREN D BOSMANS MD” Practice Location

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