Healthcare Provider Details

I. General information

NPI: 1669437257
Provider Name (Legal Business Name): JOSEPH A BOSCIA III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 HAROLD FLEMING COURT
SPARTANBURG SC
29303-4225
US

IV. Provider business mailing address

151 HAROLD FLEMING COURT
SPARTANBURG SC
29303-4225
US

V. Phone/Fax

Practice location:
  • Phone: 864-573-6320
  • Fax: 864-573-6323
Mailing address:
  • Phone: 864-573-6320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number22330
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: