Individual
ERICH BOOMGARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 UNIVERSITY BLVD, ROOM 0641 - DEPARTMENT OF RADIOLOGY AND IMAGING SCIENCE, INDIANAPOLIS, IN 46202-5149
(317) 948-2449
(317) 948-2803
Mailing address
550 UNIVERSITY BLVD, ROOM 0641 - DEPARTMENT OF RADIOLOGY AND IMAGING SCIENCE, INDIANAPOLIS, IN 46202-5149
(317) 948-2449
(317) 948-2803
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11018610A
IN
2085R0202X
Diagnostic Radiology Physician
2015017146
MO
Other
Enumeration date
06/21/2015
Last updated
06/20/2016
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