Individual ProviderJamie D. BoschPediatricsAllopathic & Osteopathic PhysiciansPractice Address1200 56th St SW, Wyoming, MI 49509-9704(616) 243-5707(616) 863-6220PECOS EnrollmentBased on the most recent information from CMS, provider Jamie D. Bosch does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 4:18 PM.Profile DetailsProvider ID1255300968Provider TypeIndividualFull NameBosch, Jamie D.TitleDr.CredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date3/15/2006Last Updated12/20/2007Contact InformationPractice LocationPractice Address1200 56th St SW, Wyoming, MI 49509-9704Phone(616) 243-5707Fax(616) 243-1170Mailing LocationMailing Address8485 Algoma Ave NE, Rockford, MI 49341-9102Phone(616) 863-6220Fax(616) 863-6221Provider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense4301070047MichiganProvider IdentifiersIDDescriptionIssuerID4738256DescriptionMedicaidIssuerUnlistedMichiganID4236290DescriptionMedicaidIssuerUnlistedMichiganID11272379DescriptionOtherIssuerCAQHMichigan