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Physician Compare National (NPI:1093796559)

HEALTHCARE PROVIDER: JULIUS BOATENG MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1093796559
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5092982645
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20120123000157
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BOATENG
Individual professional last name
Provider First Name JULIUS
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1981
Individual professional's medical school graduation year
Primary Specialty INTERNAL MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2411 W BELVEDERE AVE
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 201
Group Practice or individual's line 2 address
City BALTIMORE
Group Practice or individual's city
State MD
Group Practice or individual's state
Zip Code 212155229
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 210040
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 NORTHWEST HOSPITAL CENTER
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 210012
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 SINAI HOSPITAL OF BALTIMORE
Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment Y

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