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NPI Code Detail

MEDICARE: DR. MICHAEL DENNIS BOSAK MD

MEDICARE: DR. MICHAEL DENNIS BOSAK 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 PhysicianMD055541LPA
2207RI0011XInterventional Cardiology PhysicianMD055541LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447253612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL DENNIS BOSAK MD
Provider Business Mailing Address
First Line : 2808 OLD POST RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17110-3685
Country : US
Telephone Number : 717-920-4400
Fax Number : 717-920-4401
Provider Business Practice Location Address
First Line : 2808 OLD POST ROAD
Second Line :
City : HARRISBURG
State : PA
Zip : 17110-3685
Country : US
Telephone Number : 717-920-4400
Fax Number : 717-920-4553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 01/19/2022

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