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DEBRA R. BOENDER DPM PHD LLC NPI 1831192095


NPI Information

NPI: 1831192095
Provider Name: DEBRA R. BOENDER, DPM, PHD, LLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
26553 MARINERS RD
CRISFIELD, MD
ZIP 21817
Phone: (410) 465-4410
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DEBRA R. BOENDER, DPM, PHD, LLC is a podiatrist in Crisfield, MD. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DEBRA R. BOENDER, DPM, PHD, LLC NPI is 1831192095. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

26553 MARINERS RD
CRISFIELD, MD
ZIP 21817-109
Phone: (410) 465-4410

The provider's authorized official is Debra R Boender .
The authorized official title is Sole Practitioner/proprietor and has the following contact phone number (410) 465-4410.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 6/1/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist01409MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1K4150001OTHERMARYLANDCAREFIRST FED AND DC AREA
2=========OTHERMARYLANDPOMCO
3002485895002OTHERMARYLANDUNITED HEALTHCARE
42137828OTHERMARYLANDONE NET
501409OTHERMARYLANDMARYLAND STATE LICENSE
6689BP0/64490301OTHERMARYLANDCAREFIRST BC/BS NASCO
7002216100MEDICAIDMARYLAND
8G02100MEDICARE PINDISTRICT OF COLUMBIA
9=========OTHERMARYLANDCARE IMPROVEMENT PLUS
10V01247MEDICARE UPINMARYLAND
11DC9138OTHERMARYLANDRAILROAD MEDICARE
12606937400OTHERMARYLANDFED WORKERS COMP/DOL
13=========OTHERMARYLANDGREAT WEST
145373800001MEDICARE NSCMARYLAND
15045NMEDICARE PINMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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