Healthcare Provider Details

I. General information

NPI: 1225007198
Provider Name (Legal Business Name): STEVEN A BOSKOVICH MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 S LINDEN RD
FLINT MI
48532-3407
US

IV. Provider business mailing address

1290 S LINDEN RD
FLINT MI
48532-3407
US

V. Phone/Fax

Practice location:
  • Phone: 810-732-6231
  • Fax: 810-732-0725
Mailing address:
  • Phone: 810-732-6231
  • Fax: 810-732-0725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN ALLEN BOSKOVICH
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 810-732-6231