Boedeker, Edgar C.
Boedeker, Edgar C. is an individual health care provider with primary practice located at 1001 Dr Martin Luther King Jr Ave Ne , Albuquerque NM 87106-4713. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Boedeker, Edgar C. can be contacted via phone (505) 925-6000.Contact Information
Primary practice address
1001 Dr Martin Luther King Jr Ave Ne
Albuquerque NM 87106-4713
Phone: (505) 925-6000
Fax: (505) 272-8018
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | MD2005-0398 | New Mexico |
Profile Details
| NPI number | 1861586935 |
|---|---|
| LBN Legal business name | Boedeker, Edgar C. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | May 17th, 2012 - about 13 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 | 1861586935 | NPPES |
| Colorado | MEDICAID | 43351841 | |
| Colorado | MEDICAID | 989444 | |
| Colorado | MEDICAID | 46554548 |
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