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General NPI Number Information
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NPI Number | 1427283217
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Entity Type | Individual
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Provider Name | ELIZABETH BOZEMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 3605 PETERS CT
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City | HIGH POINT
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State | NC
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Zip | 27265-9004
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Country | US
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Telephone | 336-841-1850
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Fax | 336-841-1855
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Provider Business Mailing Address
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Address Line | 5340 MERCIA CT
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City | WINSTON SALEM
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State | NC
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Zip | 27106-9804
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Country | US
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Telephone | 336-922-1186
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2005-00795
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License Number State | NC
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