Individual
DR. ROGER O BOYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3803 SPRING STREET, SUITE 600, RACINE, WI 53405-1660
(262) 687-8312
(262) 687-8312
Mailing address
3803 SPRING STREET, SUITE 600, RACINE, WI 53405-1660
(262) 687-8312
(262) 687-8796
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036085330
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036085330
IL
207RP1001X
Pulmonary Disease Physician
036085330
IL
207RP1001X
Pulmonary Disease Physician
Primary
50632
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085330
—
IL
01
—
1633677
BLUE CROSS PROVIDER #
IL
Enumeration date
09/04/2006
Last updated
12/06/2010
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