Healthcare Provider Details

I. General information

NPI: 1811970155
Provider Name (Legal Business Name): PAUL F BOSTROM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 VILLAGE SQ
CHELMSFORD MA
01824-2712
US

IV. Provider business mailing address

526 MAIN ST STE 302
ACTON MA
01720-3301
US

V. Phone/Fax

Practice location:
  • Phone: 978-244-0060
  • Fax: 978-244-2522
Mailing address:
  • Phone: 978-371-7010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number272933
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number272933
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: