Individual
TIMOTHY CAPERS BOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(866) 828-1780
Mailing address
12410 MILESTONE CENTER DR, MEDICAL EMERGENCY PROFESSIONALS, SUITE 225, GERMANTOWN, MD 20876-7101
(866) 828-1780
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001834
VA
363A00000X
Physician Assistant
C0002904
MD
Other
Enumeration date
07/17/2006
Last updated
02/20/2013
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