Individual
JOHN R BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2629 N 7TH ST, SHEBOYGAN, WI 53083-4932
(920) 451-5553
(920) 451-5113
Mailing address
2629 N 7TH ST, SHEBOYGAN, WI 53083-4932
(920) 451-5553
(920) 451-5113
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27561
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104363050
—
MI
05
—
30735200
—
WI
01
—
930111410
RAILROAD
WI
Enumeration date
06/28/2006
Last updated
08/26/2008
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