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General NPI Number Information
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NPI Number | 1093713208
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Entity Type | Individual
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Provider Name | KRISTIN A BOEHM M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1800 HOWELL MILL RD NW STE 400
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City | ATLANTA
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State | GA
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Zip | 30318-0919
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Country | US
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Telephone | 404-881-0687
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Fax | 404-873-9192
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Provider Business Mailing Address
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Address Line | 922 HIGHLAND VW NE
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City | ATLANTA
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State | GA
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Zip | 30306-3817
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Country | US
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Telephone | 404-449-6187
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 050130
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License Number State | GA
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