Organization
BOMAN SURGICAL SPECIALISTS,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARS BOMAN M.D. (PRESIDENT-OWNER)
(508) 679-7369
Entity
Organization
Contact information
Practice address
300 HANOVER ST, SUITE 1A, FALL RIVER, MA 02720-5444
(508) 679-7369
(508) 679-7750
Mailing address
300 HANOVER ST, SUITE 1A, FALL RIVER, MA 02720-5444
(508) 679-7369
(508) 679-7750
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
60137
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BC BS OF MA
M18033
MA
05
—
BS44124
—
MA
01
—
D165
HARVARD PILGRIM
MA
Enumeration date
04/09/2007
Last updated
08/22/2020
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