Boardman, Peter
Boardman, Peter is an individual health care provider with primary practice located at 3931 Louisiana Ave S , St Louis Park MN 55426-5000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Boardman, Peter can be contacted via phone (952) 993-3230.Contact Information
Primary practice address
3931 Louisiana Ave S
St Louis Park MN 55426-5000
Phone: (952) 993-3230
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 48106 | Minnesota |
Profile Details
| NPI number | 1376500389 |
|---|---|
| LBN Legal business name | Boardman, Peter |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Jul 29th, 2021 - about 3 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 | 1376500389 | NPPES |
| Minnesota | MEDICAID | 617667400 |
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