Healthcare Provider Details

I. General information

NPI: 1225598881
Provider Name (Legal Business Name): ADAM BOSSERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 W BUTLER PIKE
AMBLER PA
19002-5156
US

IV. Provider business mailing address

813 W BUTLER PIKE
AMBLER PA
19002-5156
US

V. Phone/Fax

Practice location:
  • Phone: 215-520-5902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC1-0025998
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: