Individual
DR. MICHAEL D BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 W HOSPITAL RD, MEB SECTION, FORT GORDON, GA 30905-5741
(706) 787-9136
(706) 787-9136
Mailing address
300 W HOSPITAL RD, MEB SECTION, FORT GORDON, GA 30905-5741
(706) 787-9136
(706) 787-9136
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME55585
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271186900
—
FL
01
—
34-1371375
FEI
FL
01
—
P00699936
RAILROAD MEDICARE
—
01
—
P00830193
RAILROAD MEDICARE ATTACHED TO GRP DQ3034
—
Enumeration date
07/18/2006
Last updated
10/03/2013
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