Individual
MARIE VALE BOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
28455 HAGGERTY RD, STE 200, NOVI, MI 48377-2982
(248) 893-3200
(248) 893-2950
Mailing address
6676 SOLUTIONS CTR, CHICAGO, IL 60677-6006
(248) 893-3200
(248) 893-2951
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001569
MI
Other
Enumeration date
07/12/2007
Last updated
12/29/2015
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