MEDICARE: MICHAEL WILLIAM BOYD A.O.

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	225000000X	Orthotic Fitter
2	156FX1700X	Ocularist	27-3468101	NC
3	1744P3200X	Prosthetics Case Management	27-3468101	NC

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	023UX	OTHER	NC	BLUE CROSS BULE SHIELD

General Provider Information

NPI Number	:	1770701526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL WILLIAM BOYD A.O.

Provider Business Mailing Address
First Line	:	1736 MAPLE AVE
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-6846
Country	:	US
Telephone Number	:	336-228-1403
Fax Number	:	336-228-1503

Provider Business Practice Location Address
First Line	:	1736 MAPLE AVE
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-6846
Country	:	US
Telephone Number	:	336-228-1403
Fax Number	:	336-228-1503

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

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/18/2013

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