MEDICARE: DR. MICHAEL J. BOYER DPM

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	213E00000X	Podiatrist	36002426	OH
2	213EP1101X	Primary Podiatric Medicine Podiatrist	36002426	OH

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

General Provider Information

NPI Number	:	1447251624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J. BOYER DPM

Provider Business Mailing Address
First Line	:	119 BROAD STREET
Second Line	:
City	:	WADSWORTH
State	:	OH
Zip	:	44281-2286
Country	:	US
Telephone Number	:	330-334-1534
Fax Number	:	330-334-1535

Provider Business Practice Location Address
First Line	:	119 BROAD ST
Second Line	:
City	:	WADSWORTH
State	:	OH
Zip	:	44281-1851
Country	:	US
Telephone Number	:	330-334-1534
Fax Number	:	330-334-1535

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	05/02/2008

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