Individual
DR. GREGORY BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 MERCY DR NW, SUITE 319, CANTON, OH 44708-2626
(330) 580-4706
(330) 580-4707
Mailing address
1330 MERCY DR NW, SUITE 319, CANTON, OH 44708-2626
(330) 580-4706
(330) 580-4707
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35052710
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000600139
ANTHEM BC/BS
OH
05
—
0776665
—
OH
01
—
1700048
UNITED HEALTHCARE
OH
01
—
2157366
GROUP MEDICAID
OH
01
—
67552
FIRST HEALTH
OH
01
—
9303389
GROUP MEDICARE MPCC
OH
Enumeration date
07/12/2005
Last updated
02/01/2010
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