Provider Demographics
NPI:1962404046
Name:BOYLAN, DOUGLAS N (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:N
Last Name:BOYLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:800 W STATE ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2250
Mailing Address - Country:US
Mailing Address - Phone:215-348-3068
Mailing Address - Fax:215-348-7428
Practice Address - Street 1:800 W STATE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2250
Practice Address - Country:US
Practice Address - Phone:215-348-3068
Practice Address - Fax:215-348-7428
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD068120L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA026442Medicare PIN
PAG80807Medicare UPIN
PA026442KWXMedicare ID - Type Unspecified