Provider Demographics
NPI:1427148345
Name:NORMAN R. BOEVE, M.D.,P.C.
Entity type:Organization
Organization Name:NORMAN R. BOEVE, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BOEVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-846-4530
Mailing Address - Street 1:1310 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2472
Mailing Address - Country:US
Mailing Address - Phone:616-846-4530
Mailing Address - Fax:616-846-9271
Practice Address - Street 1:1310 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2472
Practice Address - Country:US
Practice Address - Phone:616-846-4530
Practice Address - Fax:616-846-9271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0709934Medicare ID - Type Unspecified
MIA78217Medicare UPIN