Individual
WILLEM H BOOM
Active
Individual
WILLEM H BOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
35-057716
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224351
UNISON
—
01
—
000000539533
ANTHEM
—
01
—
0642326
AETNA
OH
05
—
0728163
—
OH
01
—
363372
WELLCARE
—
01
—
700006744
RAILROAD MEDICARE
OH
01
—
746006
BUCKEYE
OH
01
—
P00449264
RAILROAD MEDICARE
OH
Enumeration date
07/19/2006
Last updated
12/10/2020
Update your record
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