Boertje, Douglas Lee

Boertje, Douglas Lee is an individual health care provider with primary practice located at 501 S Sharon Amity Rd Ste 300 , Charlotte NC 28211-0035. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as his primary health care specialty. Boertje, Douglas Lee can be contacted via phone (704) 377-2424.

Contact Information

Primary practice address
501 S Sharon Amity Rd Ste 300 Charlotte NC 28211-0035
Phone: (704) 377-2424
Fax: (704) 377-2687
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X 2006-01516 North Carolina
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X 36257 Tennessee

Profile Details

NPI number 1558361246
LBN Legal business name Boertje, Douglas Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2005
Last updated Aug 23rd, 2023 - about last year

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 1558361246 NPPES
South Carolina Other N01517 SC MEDICAID
South Carolina MEDICAID 59-05661 SC MEDICAID

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