Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D0050899 | MD |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | D0050899 | MD |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D0050899 | MD |
Y | 207XX0801X | Orthopaedic Trauma Surgeon | D0050899 | MD |
NPI | 1184713661 |
---|---|
Provider Name | Dr. Barry P Boden |
First Address | Rockville, MD 20850-3334 |
Second Address | Rockville, MD 20850-3334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 10/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
093557 | ANTHEM (01) | |
217566133 | TRICARE (01) | |
347535 | ALLIANCE/MAMSI (01) | |
347535 | MDIPA/OPCHOICE (01) | |
37520008 | BLUE CROSS OF NATL CAP AR (01) | |
5405091004 | CIGNA (01) | |
54223602 | CAREFIRST BLUE CROSS (01) | |
G20290 | (02) |