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Individual

DR. FRED EDWARD BOEHMKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8201 MAIN ST, SUITE 8, WILLIAMSVILLE, NY 14221-6046
(716) 626-6626
(716) 626-6646
Mailing address
8201 MAIN ST, SUITE 8, WILLIAMSVILLE, NY 14221-6046
(716) 626-6626
(716) 626-6646

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
130603
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00668933
NY
Enumeration date
04/20/2006
Last updated
07/08/2007
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