Healthcare Provider Details

I. General information

NPI: 1760549281
Provider Name (Legal Business Name): DEBRA L. BOYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 06/21/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 PACKARD RD
YPSILANTI MI
48197-2060
US

IV. Provider business mailing address

2900 PACKARD RD STE 1
YPSILANTI MI
48197-2061
US

V. Phone/Fax

Practice location:
  • Phone: 734-572-8686
  • Fax: 734-572-8866
Mailing address:
  • Phone: 734-572-8686
  • Fax: 734-572-8866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301053018
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: