Provider Demographics
NPI:1386621571
Name:BOEHM, CURTIS A (MD)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:A
Last Name:BOEHM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:PO BOX 43
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440
Mailing Address - Country:US
Mailing Address - Phone:612-262-1166
Mailing Address - Fax:612-262-4258
Practice Address - Street 1:1021 BANDANA BLVD E
Practice Address - Street 2:STE 100
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108
Practice Address - Country:US
Practice Address - Phone:651-241-9700
Practice Address - Fax:651-241-9678
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2020-11-10
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Provider Licenses
StateLicense IDTaxonomies
MN36989207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN779323500Medicaid
MN110002981Medicare ID - Type Unspecified
MNF96937Medicare UPIN