Individual
OTTO ROBERT BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2630 E 7TH ST, SUITE 100, CHARLOTTE, NC 28204-4319
(704) 372-7900
(704) 376-2216
Mailing address
2630 E 7TH ST, SUITE 100, CHARLOTTE, NC 28204-4319
(704) 372-7900
(704) 376-2216
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
21627
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01284
BCBS
NC
05
—
8916409
—
NC
Enumeration date
07/12/2006
Last updated
11/21/2007
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