Individual
MARK T BOEHNERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
133 BROOKLINE AVE, PEDIATRICS DEPT, BOSTON, MA 02215-3904
(617) 421-8888
(617) 421-8733
Mailing address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-8888
(617) 421-8733
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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