Healthcare Provider Details
I. General information
NPI: 1912023391
Provider Name (Legal Business Name): ANNE JAMES BOYD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/21/2007
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5301 MCAULEY DR
YPSILANTI MI
48197-1051
US
IV. Provider business mailing address
5301 MCAULEY DR
YPSILANTI MI
48197-1051
US
V. Phone/Fax
- Phone: 734-712-3325
- Fax: 734-712-5525
- Phone: 734-712-3325
- Fax: 734-712-5525
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 4301061698 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 4301061698 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: