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General NPI Number Information
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NPI Number | 1063738219
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Entity Type | Individual
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Provider Name | MARIBETH HAMRICK BOSSHARDT M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 605 GLENWOOD DR STE 200
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1130
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Country | US
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Telephone | 423-698-1844
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Fax | 423-624-2226
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Provider Business Mailing Address
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Address Line | P.O. BOX 440100
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City | NASHVILLE
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State | TN
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Zip | 37244
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Country | US
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Telephone | 615-329-0570
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Fax | 615-329-0579
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 36717
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 36717
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 48458
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License Number State | TN
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