Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 213054 | MA |
Y | 2080P0214X | Pediatric Pulmonologist | 213054 | MA |
NPI | 1659461929 |
---|---|
Provider Name | Dr. Debra M Boyer |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2006 |
Last Update Date | 07/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0173070 | (05) | MA |
G75973 | (02) |