Healthcare Provider Details

I. General information

NPI: 1881606945
Provider Name (Legal Business Name): PATRICK J BOSQUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST MC 4000
DENVER CO
80204-4507
US

IV. Provider business mailing address

777 BANNOCK ST MC 4000
DENVER CO
80204-4507
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-6899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number39936
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: