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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1093719338 NPPES
Nevada MEDICAID 002002951
Nevada Other NV 2996

Popular Providers