Healthcare Provider Details

I. General information

NPI: 1669544037
Provider Name (Legal Business Name): RODERICK J BOYES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18181 OAKWOOD BLVD STE 208
DEARBORN MI
48124-5032
US

IV. Provider business mailing address

18181 OAKWOOD BLVD STE 208
DEARBORN MI
48124-5032
US

V. Phone/Fax

Practice location:
  • Phone: 313-271-5565
  • Fax: 313-271-1053
Mailing address:
  • Phone: 313-271-5565
  • Fax: 313-271-1053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number4301044132
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0061434
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: