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Individual
EDGAR ALAN BOONE
Active
Individual
EDGAR ALAN BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD027914E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000067334
HIGHMARK
PA
05
—
0010968930002
—
PA
01
—
010028191
PALMETTO GBA RR MEDICARE
PA
01
—
0473267
AETNA
PA
01
—
104152
UPMC HEALTH PLAN
PA
01
—
1409575
UNITED MINE WORKERS
PA
01
—
1427335140
WHITERIVER
—
01
—
1427335181
CBQ
—
Enumeration date
07/18/2005
Last updated
04/03/2012
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