Individual
DR. ALLEN MICHAEL BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 N 10TH ST, BISMARCK, ND 58501-4516
(701) 530-7500
(701) 530-7484
Mailing address
310 N 10TH ST, BISMARCK, ND 58501-4516
(701) 530-7500
(701) 530-7484
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
5739
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568562098
NPI
ND
01
—
P00207754
RAILROAD MEDICARE
ND
Enumeration date
09/24/2006
Last updated
02/28/2008
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