Provider Demographics
NPI:1205319159
Name:KALAMPANAYIL, BOSE (PHD)
Entity type:Individual
Prefix:DR
First Name:BOSE
Middle Name:
Last Name:KALAMPANAYIL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15315 HOLLY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-3862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15315 HOLLY GROVE RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-3862
Practice Address - Country:US
Practice Address - Phone:800-270-1862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1411NRCC207ZP0104X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology