Boardman, John R
Boardman, John R is an individual health care provider with primary practice located at 2629 N 7Th St , Sheboygan WI 53083-4932. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Boardman, John R can be contacted via phone (920) 451-5553.Contact Information
Primary practice address
2629 N 7Th St
Sheboygan WI 53083-4932
Phone: (920) 451-5553
Fax: (920) 451-5113
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 27561 | Wisconsin |
Profile Details
| NPI number | 1487682696 |
|---|---|
| LBN Legal business name | Boardman, John R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Aug 26th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487682696 | NPPES |
| Wisconsin | MEDICAID | 30735200 | |
| Wisconsin | MEDICAID | 104363050 | |
| Wisconsin | Other | 930111410 |
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