| Marc Bostick Md Chartered | |
|
413 N Allumbaugh St Ste 101 Boise ID 83704-9219 | |
| (208) 323-1125 | |
| (208) 323-9604 |
| Full Name | Marc Bostick Md Chartered |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 413 N Allumbaugh St, Boise, Idaho |
| Authorized Official Name and Position | Cheri Peterson (CREDENTIALER) |
| Authorized Official Contact | 2089545594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marc Bostick Md Chartered 413 N Allumbaugh St Ste 101 Boise ID 83704-9219 Ph: (208) 323-1125 | Marc Bostick Md Chartered 413 N Allumbaugh St Ste 101 Boise ID 83704-9219 Ph: (208) 323-1125 |
| NPI Number | 1508034802 |
|---|---|
| Provider Enumeration Date | 02/20/2008 |
| Last Update Date | 04/21/2021 |
| Certification Date | 04/21/2021 |
| Medicare PECOS PAC ID | 2769433341 |
|---|---|
| Medicare Enrollment ID | O20050201001023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508034802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M7712 (Idaho) | Primary |
| Provider Name | Marc W Bostick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073545703 PECOS PAC ID: 4880645456 Enrollment ID: I20050201000929 |
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