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NPI Code Detail

MEDICARE: DR. ANNETTE KAREN BOER MD

MEDICARE: DR. ANNETTE KAREN BOER 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
1204C00000XSports Medicine (Neuromusculoskeletal Medicine) Physician54085OH

General Provider Information

NPI Number : 1659357226
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANNETTE KAREN BOER MD
Provider Business Mailing Address
First Line : 3829 CHISELHURST PL
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-4722
Country : US
Telephone Number : 614-457-1352
Fax Number :
Provider Business Practice Location Address
First Line : 2030 STRINGTOWN RD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-3993
Country : US
Telephone Number : 614-544-0030
Fax Number : 614-544-0031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 07/08/2007

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