Healthcare Provider Details

I. General information

NPI: 1992750319
Provider Name (Legal Business Name): MARGARET B BOYSE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 LAKE BOONE TRL SUITE 200
RALEIGH NC
27607-7511
US

IV. Provider business mailing address

4201 LAKE BOONE TRL SUITE 200
RALEIGH NC
27607-7511
US

V. Phone/Fax

Practice location:
  • Phone: 919-782-2152
  • Fax: 919-782-7929
Mailing address:
  • Phone: 919-782-2152
  • Fax: 919-782-7929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number200301332
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: