Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 6724 | NV |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 6724 | NV |
NPI | 1518948512 |
---|---|
Provider Name | Eric Martin Boyden |
First Address | Reno, NV 89503-4723 |
Second Address | Reno, NV 89503-4723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11307421 | CAQH (01) | |
20-16625 | (05) | NV |
E59759 | (02) | NV |