Individual
CHARLES RUSSELL BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
84 MARGINAL WAY STE 700, PORTLAND, ME 04101-2481
(207) 774-5816
(207) 987-5245
Mailing address
84 MARGINAL WAY STE 700, PORTLAND, ME 04101-2481
(207) 774-5816
(207) 987-5245
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN30687
ME
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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