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NPI Code Detail

MEDICARE: DR. ALLAN JAMES BOYUM M.D.

MEDICARE: DR. ALLAN JAMES BOYUM M.D.
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
1207R00000XInternal Medicine Physician15643MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528009735
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLAN JAMES BOYUM M.D.
Provider Business Mailing Address
First Line : 26242 STILLWATER CIR
Second Line :
City : PUNTA GORDA
State : FL
Zip : 33955-4731
Country : US
Telephone Number : 612-423-1127
Fax Number :
Provider Business Practice Location Address
First Line : 26242 STILLWATER CIR
Second Line :
City : PUNTA GORDA
State : FL
Zip : 33955-4731
Country : US
Telephone Number : 612-423-2202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 10/02/2018

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