Boetticher, Nicholas Carl
Boetticher, Nicholas Carl is an individual health care provider with primary practice located at 1185 Town Centre Dr , Eagan MN 55123-1187. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Boetticher, Nicholas Carl can be contacted via phone (612) 871-1145.Contact Information
Primary practice address
1185 Town Centre Dr
Eagan MN 55123-1187
Phone: (612) 871-1145
Fax: (612) 870-5491
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 46944 | Minnesota |
Profile Details
| NPI number | 1295706620 |
|---|---|
| LBN Legal business name | Boetticher, Nicholas Carl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2006 |
| Last updated | May 20th, 2014 - about 10 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 | 1295706620 | NPPES |
| Minnesota | MEDICAID | 906473700 |
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