Boogaart, Damon M

Boogaart, Damon M is an individual health care provider with primary practice located at 2570 Som Center Rd , Willoughby OH 44094-9607. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Boogaart, Damon M can be contacted via phone (440) 943-2500.

Contact Information

Primary practice address
2570 Som Center Rd Willoughby OH 44094-9607
Phone: (440) 943-2500
Fax: (440) 516-8345
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71000544A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP 08627 Ohio

Profile Details

NPI number 1538160403
LBN Legal business name Boogaart, Damon M
Credentials DNP, CFNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Apr 17th, 2015 - 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 1538160403 NPPES
Indiana Other 000000297161 BC/BS #
Indiana MEDICAID 100321450 BC/BS #
Indiana MEDICAID 2288117 BC/BS #

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