Individual
CAMERICA S. BOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
45 THOMAS JOHNSON DR, SUITE 207, FREDERICK, MD 21702-4425
(301) 694-3400
(301) 694-3620
Mailing address
PO BOX 790058, SAINT LOUIS, MO 63179-0058
(636) 549-2380
(314) 569-5974
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AC000517
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4191765 00
—
MD
01
—
KBC1CH
CAREFIRST BCBS
MD
01
—
P00745067
MEDICARE RAILROAD
MD
01
—
S417 0025
CAREFIRST BCBS
DC
Enumeration date
02/19/2008
Last updated
04/20/2010
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