Individual
DR. DOUGLAS LEE BOERTJE
Active
Individual
DR. DOUGLAS LEE BOERTJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
2006-01516
NC
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
36257
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59-05661
—
NC
01
—
N01517
SC MEDICAID
SC
Enumeration date
07/26/2005
Last updated
08/23/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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