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General NPI Number Information
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NPI Number | 1558652727
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Entity Type | Individual
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Provider Name | ANTHONY BOZZIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 1400 MERCY DR STE 100
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City | MUSKEGON
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State | MI
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Zip | 49444-1833
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Country | US
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Telephone | 231-733-1326
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Fax |
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Provider Business Mailing Address
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Address Line | 4048 CEDAR BLUFF DR STE 1
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City | PETOSKEY
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State | MI
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Zip | 49770-8895
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Country | US
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Telephone | 231-347-5155
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | Q8697
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301111317
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License Number State | MI
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