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NPI Code Detail

MEDICARE: MATTHEW P BOENTE M.D.

MEDICARE: MATTHEW P BOENTE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VG0400XGynecology Physician43370MN
2207VX0201XGynecologic Oncology Physician43370MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11027340OTHERMNPREFERREDONE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3529T1BOOTHERMNBLUE CROSS BLUE SHIELD
40703893OTHERMNMEDICA
5151532OTHERMNUCARE MN
61282470OTHERMNAMERICA'S PPO
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8HP32764OTHERMNHEALTHPARTNERS

General Provider Information

NPI Number : 1336116391
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW P BOENTE M.D.
Provider Business Mailing Address
First Line : 6545 FRANCE AVE S
Second Line : SUITE 210
City : EDINA
State : MN
Zip : 55435-2281
Country : US
Telephone Number : 952-928-2900
Fax Number : 952-928-2944
Provider Business Practice Location Address
First Line : 6545 FRANCE AVE S
Second Line : SUITE 210
City : EDINA
State : MN
Zip : 55435-2281
Country : US
Telephone Number : 952-928-2900
Fax Number : 952-928-2944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 10/13/2011

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Directions to “ MATTHEW P BOENTE M.D.” Practice Location

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