Individual
ROSEMARIE BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5501 OLD YORK RD, 4TH FLOOR, PHILADELPHIA, PA 19141-3018
(215) 456-7900
(215) 456-5948
Mailing address
PO BOX 8500-8735, PHILADELPHIA, PA 19178-0001
(215) 456-7000
(215) 254-2599
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
25MA06079800
NJ
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD419220
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2081676000
IBC NJ
NJ
01
—
2458042
CIGNA
NJ
01
—
2845979000
IBC PA
PA
01
—
5551738
AETNA
NJ
Enumeration date
11/14/2006
Last updated
07/19/2012
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