Provider Demographics
NPI:1902083546
Name:BOZEMAN, ANDREW P (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:P
Last Name:BOZEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 MEDICAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2561
Mailing Address - Country:US
Mailing Address - Phone:478-272-2707
Mailing Address - Fax:478-272-2791
Practice Address - Street 1:100 MEDICAL DR STE 100
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2561
Practice Address - Country:US
Practice Address - Phone:478-272-2707
Practice Address - Fax:478-272-2791
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0655262086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery