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General NPI Number Information
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NPI Number | 1427336817
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Entity Type | Individual
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Provider Name | MARY NEELEY BOYCE PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/02/2011
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 125 SHOREWAY DR STE 120
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City | QUEENSTOWN
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State | MD
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Zip | 21658-1681
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Country | US
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Telephone | 410-827-4001
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Fax | 410-827-4333
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Provider Business Mailing Address
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Address Line | 7580 BUCKINGHAM BLVD STE 200
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City | HANOVER
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State | MD
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Zip | 21076-3210
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Country | US
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Telephone | 410-729-5140
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-02843
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C006881
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License Number State | MD
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