Organization
B R BOEHMER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNARD R BOEHMER MD PA (OWNER)
(208) 878-2271
Entity
Organization
Contact information
Practice address
1335 ALBION AVE, BURLEY, ID 83318-1817
(208) 878-2271
Mailing address
1335 ALBION AVE, BURLEY, ID 83318-1817
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
M6848
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002799800
—
ID
Enumeration date
08/12/2010
Last updated
08/12/2010
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