Doctor Name: | DR. GREGORY X BOEHM |
NPI Number: | 1972678894 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 35-04-1394-B |
Business Practice Address: | 26777 Lorain Rd Suite 716 North Olmsted, OH - 440703200 |
Business Phone Number: | 4407779200 |
Business Fax Number: | 4407779288 |
Mailing Address: | 26777 Lorain Rd, Suite 716 NORTH OLMSTED |
State: | OH |
Postal Code: | 440703200 |
Phone Number: | 4407779200 |
Fax Number: | 4407779288 |
NPI Enumeration Date: | 11/24/2006 |
NPI Last Update Date: | 03/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 35-04-1394-B |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |