Provider Demographics
NPI:1992759294
Name:BOYKO, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:BOYKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-0276
Mailing Address - Country:US
Mailing Address - Phone:540-209-0904
Mailing Address - Fax:540-833-6668
Practice Address - Street 1:281 N. MASON STREET
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22803-0276
Practice Address - Country:US
Practice Address - Phone:540-209-0904
Practice Address - Fax:540-833-6668
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21412207P00000X
VA0101038103207P00000X
PAMD434415207P00000X
KY43221207P00000X
OH35-090652207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVB08593Medicare UPIN
VAB08593Medicare UPIN