Provider Demographics
NPI:1154397677
Name:BOVERI, JOSEPH F (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:BOVERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1067 STOVALL BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1220
Mailing Address - Country:US
Mailing Address - Phone:404-312-1047
Mailing Address - Fax:404-481-2176
Practice Address - Street 1:5430 GLENRIDGE DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1342
Practice Address - Country:US
Practice Address - Phone:404-250-3600
Practice Address - Fax:404-481-2176
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA38693207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I160399Medicare PIN
GA16BBCSHMedicare ID - Type Unspecified
A13781Medicare UPIN