Individual
MR. ROGER MELVIN BOETTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 ELM ST N, ONAMIA, MN 56359-7901
(320) 532-3154
(320) 532-3111
Mailing address
200 ELM ST N, ONAMIA, MN 56359-7901
(320) 532-3154
(320) 532-3111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28490
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-21010
MEDICA ONAMIA
MN
01
—
01-21114
MEDICA ISLE CLINIC
MN
01
—
01-21117
MEDICA HILLMAN CLINIC
MN
01
—
109558
UCARE
MN
05
—
206780300
—
MN
01
—
340G8BO
BLUE CROSS CLINICS
MN
01
—
340G9BO
BLUE CROSS HOSPITAL
MN
01
—
NA9090253011
PREFERRED ONE
MN
Enumeration date
05/18/2006
Last updated
09/08/2014
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