Provider Demographics
NPI:1780974022
Name:BOSSERT, WILLIAM B (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:BOSSERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-262-2665
Mailing Address - Fax:717-267-0159
Practice Address - Street 1:755 NORLAND AVE
Practice Address - Street 2:STE 101
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4221
Practice Address - Country:US
Practice Address - Phone:717-262-2665
Practice Address - Fax:717-267-0159
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4507752084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103024869Medicaid
PA103024869Medicaid
PAP01527761Medicare PIN