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Individual

PAMELA BOYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
9908 SR 64 EAST, BRADENTON, FL 34212-5303
(941) 747-8600
(941) 749-5915
Mailing address
367 S. GULPH RD, ATT: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(775) 356-9393
(775) 356-5590

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OS9561
FL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
C20006889
DE
208D00000X
General Practice Physician
Primary
OS9561
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01694651
RR MEDICARE
FL
Enumeration date
08/14/2006
Last updated
09/27/2017
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