Organization Name: | DAVID P. BOERSMA, M.D., L.L.C. |
NPI Number: | 1154633881 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID P BOERSMA (OWNER/PCP) |
Mailing Address: | 7505 Osler Dr Ste 510 Towson |
State: | MD US |
Postal Code: | 212047740 |
Phone Number: | 4108235532 |
Fax Number: | 4108235703 |
NPI Enumeration Date: | 07/10/2010 |
NPI Last Update Date: | 04/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | D0040048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |