Individual
ELISABETH B BOELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1040 MEDICAL PARK AVE, NEW BERN, NC 28562-5248
(252) 633-1678
(252) 633-1403
Mailing address
1040 MEDICAL PARK AVE, NEW BERN, NC 28562-5248
(252) 633-1678
(252) 633-1403
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001006899
NC
363A00000X
Physician Assistant
5601006447
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447509252
—
NC
Enumeration date
09/07/2012
Last updated
12/28/2016
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