Individual
MR. MARK A BOOMERSHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3496 E LAKE LANSING RD, SUITE 100, EAST LANSING, MI 48823-2288
(517) 333-0968
(517) 333-4306
Mailing address
3496 E LAKE LANSING RD, SUITE 100, EAST LANSING, MI 48823-2288
(517) 333-0968
(517) 333-4306
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001393
MI
Other
Enumeration date
09/12/2007
Last updated
03/07/2023
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