Individual
TOD OWEN BOEHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C., C.C.S.P.
Contact information
Practice address
2855 CHESAPEAKE BCH RD W, DUNKIRK, MD 20754-9530
(410) 257-9762
(410) 257-9738
Mailing address
6549 LONG BEACH DR, SAINT LEONARD, MD 20685-2541
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
SO1535
MD
111NS0005X
Sports Physician Chiropractor
SO1535
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2037667
AETNA HMO
MD
01
—
222997060
CIGNA
MD
01
—
4609048
AETNA PPO
MD
01
—
54238101
BCBS MD PROF RENDERING #
MD
01
—
F173-0001
FEDERAL BCBS
MD
01
—
M265
CAREFIRST BCBS OF MD
MD
Enumeration date
02/23/2007
Last updated
10/28/2015
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