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NPI Code Detail

MEDICARE: ABHISHEK BOSE MD

MEDICARE: ABHISHEK BOSE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician57791KY
2207RC0001XClinical Cardiac Electrophysiology Physician57791KY

General Provider Information

NPI Number : 1245493451
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABHISHEK BOSE MD
Provider Business Mailing Address
First Line : PO BOX 776351
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6351
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6420 DUTCHMANS PKWY STE 200
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-3373
Country : US
Telephone Number : 502-891-8300
Fax Number : 502-891-8338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2008
Last Update Date : 12/13/2024

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