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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558320051 NPPES
Indiana Other IN01028548 IN LIC #
Indiana Other 000000355597 IN LIC #
Indiana MEDICAID 100216200 IN LIC #

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