Individual
ANDREA L BOYD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
SPA-C
Contact information
Practice address
7255 OLD OAK BLVD, CLEVELAND, OH 44130-3329
(440) 891-8878
Mailing address
7255 OLD OAK BLVD, CLEVELAND, OH 44130-3300
(440) 891-8878
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50-00-1351
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000378376
ANTHEM
OH
05
—
0835127
—
OH
01
—
100524842011
MEDICAL MUTUAL
OH
01
—
2968745919-00
BWC
OH
01
—
4078243
AETNA
OH
01
—
52954
QUAL CHOICE
OH
01
—
P00242414
RAILROAD MEDICARE
OH
Enumeration date
02/06/2006
Last updated
07/08/2007
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