Provider Demographics
NPI:1932171592
Name:BOXER, RICHARD JAMES (M D)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:BOXER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2627 S BAYSHORE DR
Mailing Address - Street 2:APT. 2502
Mailing Address - City:COCONUT GROVE
Mailing Address - State:FL
Mailing Address - Zip Code:33133-5438
Mailing Address - Country:US
Mailing Address - Phone:414-803-6768
Mailing Address - Fax:305-854-6770
Practice Address - Street 1:2627 S BAYSHORE DR
Practice Address - Street 2:APT. 2502
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133-5438
Practice Address - Country:US
Practice Address - Phone:414-803-6768
Practice Address - Fax:305-854-6770
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI22093208800000X
AZ13634208800000X
CAG 26969208800000X
FLME 96331208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30251500Medicaid
WI01065Medicare ID - Type Unspecified
WIB51692Medicare UPIN