Healthcare Provider Details

I. General information

NPI: 1386810026
Provider Name (Legal Business Name): MICHAEL BOIVIN MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 JONES BRIDGE RD
BETHESDA MD
20814-4712
US

IV. Provider business mailing address

8249 S MAPLE LAWN BLVD
FULTON MD
20759-2229
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-9773
  • Fax:
Mailing address:
  • Phone: 410-370-0789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number0101241282
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: