Individual
MATTHEW STEPHEN BOOHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 PILGRIM BLVD, HARTFORD CITY, IN 47348-1382
(765) 348-0300
(317) 963-5492
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01087572A
IN
207P00000X
Emergency Medicine Physician
4351045260
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300062202
—
IN
Enumeration date
06/05/2019
Last updated
05/16/2025
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