MEDICARE: WILLIAM BOYAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	MD00044635	WA
2	207RP1001X	Pulmonary Disease Physician	0101058258	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1050BO	OTHER	WA	BSWA
3	0214447	OTHER	WA	LIWA

General Provider Information

NPI Number	:	1124119144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM BOYAN MD

Provider Business Mailing Address
First Line	:	7068 WING POINT RD NE
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-2987
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7068 WING POINT RD NE
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-2987
Country	:	US
Telephone Number	:	206-335-0934
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	03/18/2011

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