MEDICARE: DR. STEVEN RANDOLPH BOYEA 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	207XS0106X	Orthopaedic Hand Surgery Physician	MD00039434	WA
2	207XS0106X	Orthopaedic Hand Surgery Physician	M-8179	ID

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	J4555	OTHER	ID	BCI
4	000010033574	OTHER	ID	REGENCE

General Provider Information

NPI Number	:	1588659866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN RANDOLPH BOYEA MD

Provider Business Mailing Address
First Line	:	320 WARNER DR
Second Line	:
City	:	LEWISTON
State	:	ID
Zip	:	83501-4441
Country	:	US
Telephone Number	:	208-743-3523
Fax Number	:	208-746-8741

Provider Business Practice Location Address
First Line	:	320 WARNER DR
Second Line	:
City	:	LEWISTON
State	:	ID
Zip	:	83501-4441
Country	:	US
Telephone Number	:	208-743-3523
Fax Number	:	208-746-8741

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	04/11/2019

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