Individual
DARREN AMUNDSEN BOYACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2214
(913) 789-3106
Mailing address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2214
(913) 789-3106
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0431179
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01674018
BCBS KCMO GROUP 01674018
—
05
—
200346760A
—
KS
05
—
200346760B
—
KS
05
—
207449406
—
MO
01
—
35924016
BCBS OF KC MO
—
01
—
35924036
BCBS KCMO GROUP 01674018
KS
01
—
P00263567
RR MEDICARE GROUP CG8899
—
01
—
P00291773
RR MEDICARE GROUP DC6712
—
Enumeration date
08/25/2005
Last updated
06/29/2021
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