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Contact Information

MARK W BOSBOUS
9200 W WISCONSIN AVENUE
PLASTIC SURGERY
MILWAUKEE, WI53226-3522
 Phone: 414-805-3666
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MARK W BOSBOUS · (Male)

NPI # 1033203906
Status Active
Credentials
Entity Individual
Enumeration date 10/03/2006
Last updated 11/27/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 49468-020
  • WI Medicaid 1033203906
Hospital affiliation(s)
  • ST JOSEPHS COM HSPTL WEST BEND - (Acute Care)
    3200 PLEASANT VALLEY ROAD
    WEST BEND, WI 53095
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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