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General NPI Number Information
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NPI Number | 1689202350
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Entity Type | Individual
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Provider Name | ALYSSA MICHELLE BOSSO MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 161 THOMAS JOHNSON DR STE 250
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City | FREDERICK
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State | MD
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Zip | 21702-4958
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Country | US
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Telephone | 301-942-7600
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Fax | 301-694-0187
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Provider Business Mailing Address
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Address Line | 7361 CALHOUN PL STE 600
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City | ROCKVILLE
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State | MD
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Zip | 20855-2788
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Country | US
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Telephone | 301-942-0442
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | D0104194
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License Number State | MD
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