Boman, Keith G
Boman, Keith G is an individual health care provider with primary practice located at 601 S Rancho Dr Ste. D-28, Las Vegas NV 89106-4899. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Boman, Keith G can be contacted via phone (702) 383-0677.Contact Information
Primary practice address
601 S Rancho Dr Ste. D-28
Las Vegas NV 89106-4899
Phone: (702) 383-0677
Fax: (702) 383-0688
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | NV4089 | Nevada |
Profile Details
| NPI number | 1093719338 |
|---|---|
| LBN Legal business name | Boman, Keith G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Mar 7th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093719338 | NPPES |
| Nevada | MEDICAID | 002002951 | |
| Nevada | Other | NV 2996 |
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