Organization
BOULEVARD INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEAL J SHERMAN M.D. (OWNER/PHYSICIAN)
(913) 248-8990
Entity
Organization
Contact information
Practice address
5701 W 110TH ST, OVERLAND PARK, KS 66211-2503
(913) 491-2400
Mailing address
PO BOX 8371, PRAIRIE VILLAGE, KS 66208-0371
(913) 248-8990
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-18169
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100113210B
—
KS
Enumeration date
07/17/2010
Last updated
07/17/2010
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