Nicole M Bossenbroek, MD | |
6225 Prairie St, Norton Shores, MI 49444-7831 | |
(231) 798-9500 | |
(231) 798-9533 |
Full Name | Nicole M Bossenbroek |
---|---|
Gender | Female |
Speciality | Dermatology |
Experience | 22 Years |
Location | 6225 Prairie St, Norton Shores, Michigan |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619909611 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ND0900X | Dermatology - Dermatopathology | 046274 (Connecticut) | Primary |
207ND0900X | Dermatology - Dermatopathology | 4301079716 (Michigan) | Secondary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Derm Institute Of West Michigan Plc | 5092044487 | 7 |
Entity Name | Lakeshore Derm & Laser Center Plc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538209945 PECOS PAC ID: 5799793006 Enrollment ID: O20060329000031 |
Entity Name | Derm Institute Of West Michigan Plc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003460874 PECOS PAC ID: 5092044487 Enrollment ID: O20190910003225 |
Mailing Address | Practice Location Address |
---|---|
Nicole M Bossenbroek, MD 6225 Prairie St, Norton Shores, MI 49444-7831 Ph: (231) 798-9500 | Nicole M Bossenbroek, MD 6225 Prairie St, Norton Shores, MI 49444-7831 Ph: (231) 798-9500 |
Timothy S Wang, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 6225 Prairie St, Norton Shores, MI 49444 Phone: 231-798-9500 Fax: 231-798-9533 | |
Dr. Jason Barrett Van Ittersum, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 6225 Prairie St, Norton Shores, MI 49444 Phone: 231-798-9500 Fax: 231-798-9533 | |
Robert A Gielczyk, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 6225 Prairie St, Norton Shores, MI 49444 Phone: 231-798-9500 Fax: 231-798-9533 |