Provider Demographics
NPI:1386810026
Name:BOIVIN, MICHAEL (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:BOIVIN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 NW 11TH ST APT B204
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-6912
Mailing Address - Country:US
Mailing Address - Phone:541-701-0165
Mailing Address - Fax:541-564-5373
Practice Address - Street 1:78798 ORDNANCE RD BLDG 11
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-9108
Practice Address - Country:US
Practice Address - Phone:541-564-5215
Practice Address - Fax:541-564-5373
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012412822083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine