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Individual
MARK T BOEHNERT
Active
Individual
MARK T BOEHNERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
53723
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015141
NEIGHBORHOOD HEALTH
MA
01
—
053723
TUFTS
MA
05
—
3191231
—
MA
01
—
J10683
BLUE CROSS
MA
01
—
PP319
HARVARD PILGRIM
MA
Enumeration date
12/15/2005
Last updated
10/22/2020
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