| Calvin Jonathan Bosman Llc | |
|
4 Carriage Ln Suite 300-c Charleston SC 29407-6065 | |
| (843) 906-7728 | |
| Not Available |
| Full Name | Calvin Jonathan Bosman Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4 Carriage Ln, Charleston, South Carolina |
| Authorized Official Name and Position | Calvin Jonathan Bosman (PSYCHIATRIST) |
| Authorized Official Contact | 8439067728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Calvin Jonathan Bosman Llc 26 Moore Dr Charleston SC 29407-7230 Ph: (843) 906-7728 | Calvin Jonathan Bosman Llc 4 Carriage Ln Suite 300-c Charleston SC 29407-6065 Ph: (843) 906-7728 |
| NPI Number | 1356617781 |
|---|---|
| Provider Enumeration Date | 03/29/2012 |
| Last Update Date | 11/15/2012 |
| Medicare PECOS PAC ID | 5193980902 |
|---|---|
| Medicare Enrollment ID | O20120628000698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356617781 | NPI | - | NPPES |
| GP5904 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 28183 (South Carolina) | Primary |
| Provider Name | Calvin J Bosman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467534370 PECOS PAC ID: 6305920141 Enrollment ID: I20080303000663 |
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