Individual
DR. ROGER W. BOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 W WHITMAN ST, POCATELLO, ID 83204-3317
(208) 233-6833
Mailing address
226 S 16TH AVE, POCATELLO, ID 83201-4003
(208) 233-5651
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
M2691
ID
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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