Provider Demographics
NPI:1891939799
Name:BOSINGER, TABITHA (PA)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:BOSINGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5308 HARROUN RD STE 280
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2190
Mailing Address - Country:US
Mailing Address - Phone:419-824-1888
Mailing Address - Fax:419-214-3074
Practice Address - Street 1:5308 HARROUN RD STE 280
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2190
Practice Address - Country:US
Practice Address - Phone:419-824-1888
Practice Address - Fax:419-214-3074
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH50.002886363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical