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Individual

MARTIN LEWIS BOONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
9000 COOMBS FARM DRIVE, SUITE 202, MORGANTOWN, WV 26508
(304) 554-0504
(304) 554-0505
Mailing address
9000 COOMBS FARM DRIVE, SUITE 202, MORGANTOWN, WV 26508
(304) 554-0504
(304) 554-0505

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
616
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
680012592
RAILROAD MEDICARE
WV
05
9201023000
WV
Enumeration date
01/26/2006
Last updated
04/08/2021
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