Individual
THOMAS CHARLES BOYSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 12TH AVE, SUITE 101, CORALVILLE, IA 52241-1774
(319) 337-3177
(319) 341-0024
Mailing address
501 12TH AVE, SUITE 101, CORALVILLE, IA 52241-1774
(319) 337-3177
(319) 341-0024
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
24303
IA
207ND0101X
MOHS-Micrographic Surgery Physician
24303
IA
207ND0900X
Dermatopathology Physician
24303
IA
207NP0225X
Pediatric Dermatology Physician
24303
IA
207NS0135X
Procedural Dermatology Physician
24303
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000A30001
UHC OF RIVER VALLEY
IA
05
—
0042135
—
IA
01
—
24829
WELLMARK BCBS
IA
Enumeration date
10/25/2006
Last updated
07/28/2008
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