Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 4301501909 | MI |
NPI | 1174058036 |
---|---|
Provider Name | Dr. Preston Joseph Boyer |
First Address | Ann Arbor, MI 48109-5718 |
Second Address | Tucson, AZ 85724-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2017 |
Last Update Date | 16/06/2020 |