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Individual
MR. ROGER MELVIN BOETTCHER
Active
Individual
MR. ROGER MELVIN BOETTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28490
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-21010
MEDICA ONAMIA
MN
01
—
01-21114
MEDICA ISLE CLINIC
MN
01
—
01-21117
MEDICA HILLMAN CLINIC
MN
01
—
109558
UCARE
MN
05
—
206780300
—
MN
01
—
340G8BO
BLUE CROSS CLINICS
MN
01
—
340G9BO
BLUE CROSS HOSPITAL
MN
01
—
NA9090253011
PREFERRED ONE
MN
Enumeration date
05/18/2006
Last updated
09/08/2014
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