Organization
DEBRA R. BOENDER, DPM, PHD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA R BOENDER D.P.M. (SOLE PRACTITIONER/PROPRIETOR)
(410) 465-4410
Entity
Organization
Contact information
Practice address
26553 MARINERS RD, CRISFIELD, MD 21817-2109
(410) 465-4410
Mailing address
26553 MARINERS RD, CRISFIELD, MD 21817-2109
(410) 465-4410
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01409
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002216100
—
MD
01
—
002485895002
UNITED HEALTHCARE
MD
01
—
01409
MARYLAND STATE LICENSE
MD
01
—
2137828
ONE NET
MD
01
—
606937400
FED WORKERS COMP/DOL
MD
01
—
689BP0/64490301
CAREFIRST BC/BS NASCO
MD
01
—
DC9138
RAILROAD MEDICARE
MD
01
—
K4150001
CAREFIRST FED AND DC AREA
MD
Enumeration date
05/23/2005
Last updated
06/01/2016
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