Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | SC006540 | PA |
N | 222Z00000X | Podiatrist | SC006540 | PA |
Y | 213ES0103X | Foot & Ankle Surgery | SC006540 | PA |
NPI | 1083998231 |
---|---|
Provider Name | Dr. Bradley Bryan Boyer |
First Address | York, PA 17402-9627 |
Second Address | York, PA 17408-4055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2011 |
Last Update Date | 16/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003059753 | HIGHMARK BC BS (01) | PA |
102932936 | (05) | PA |
4268108 | CIGNA (01) | PA |
4860021 | AETNA (01) | PA |
50125007 | CAPITAL BLUE CROSS (01) | PA |
P01355056 | PALMETTO / RAILROAD MEDICARE (01) | PA |