Provider Demographics
NPI:1487795837
Name:BOSSIE, KAREN J (DO)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:BOSSIE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:295 KENNEDY MEMORIAL DR STE 6
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4535
Mailing Address - Country:US
Mailing Address - Phone:207-623-3790
Mailing Address - Fax:207-623-3629
Practice Address - Street 1:35 MEDICAL CENTER PKWY STE 202
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8160
Practice Address - Country:US
Practice Address - Phone:207-623-3790
Practice Address - Fax:207-623-3629
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1894207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432477299Medicaid
I46421Medicare UPIN