Individual
DR. MICHAEL H. DE BOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9352 PARK WEST BLVD, KNOXVILLE, TN 37923-4325
(865) 373-1000
Mailing address
1431 CENTERPOINT BLVD, SUITE 100, KNOXVILLE, TN 37932-1984
(865) 693-1000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19872
TN
207P00000X
Emergency Medicine Physician
46604
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3096096
—
TN
01
—
4091370
BLUE CROSS
TN
05
—
64043011
—
KY
01
—
930005254
RRGA
TN
Enumeration date
06/07/2006
Last updated
03/10/2023
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