Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0101227659 | VA |
Y | 207VX0201X | Gynecologic Oncologist | 0101227659 | VA |
NPI | 1528158326 |
---|---|
Provider Name | Dr. Cecelia H Boardman |
First Address | Atlanta, GA 30384-3860 |
Second Address | Richmond, VA 23229-4942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 10/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006203094 541581185 | (05) | VA |