Boersma, Richard W
Boersma, Richard W is an individual health care provider with primary practice located at 10801 N Michigan Rd Ste 110 , Zionsville IN 46077-8171. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Boersma, Richard W can be contacted via phone (317) 344-1269.Contact Information
Primary practice address
10801 N Michigan Rd Ste 110
Zionsville IN 46077-8171
Phone: (317) 344-1269
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01028548 | Indiana |
Profile Details
NPI number | 1558320051 |
---|---|
LBN Legal business name | Boersma, Richard W |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 22nd, 2006 |
Last updated | Sep 15th, 2016 - about 9 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 | 1558320051 | NPPES |
Indiana | Other | IN01028548 | IN LIC # |
Indiana | Other | 000000355597 | IN LIC # |
Indiana | MEDICAID | 100216200 | IN LIC # |
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