Individual
DR. DEBRA R. BOENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
26553 MARINERS RD, CRISFIELD, MD 21817-2109
(443) 799-5500
Mailing address
26553 MARINERS RD, CRISFIELD, MD 21817-2109
(443) 799-5500
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
PODIATRY LICENSE MARYLAND
MD
01
—
201663779
POMCO
MD
01
—
2137828
ONE NET
MD
01
—
5373800001
DME
MD
01
—
606937400
FED WORKERS COMP
MD
01
—
689BPO/644903-01
CAREFIRST BC/BS
MD
01
—
K4150001
BC/BS FED, DC, B CHOICE
MD
01
—
RR DC9138
RR MEDICARE
MD
Enumeration date
05/23/2005
Last updated
05/01/2017
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