Individual
RICHARD B BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
800 GRAND CENTRAL MALL STE 11, VIENNA, WV 26105-4100
(304) 916-1270
(304) 916-1705
Mailing address
800 GRAND CENTRAL MALL STE 11, VIENNA, WV 26105-4100
(304) 916-1270
(304) 916-1705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1835
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1807389000
—
WV
Enumeration date
02/02/2006
Last updated
12/18/2013
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