Marilyn Jean Boehm, MD, PHD
Individual provider Active NPI Family Medicine Physician · Hubert, NC
NPI 1790977759 · NPPES record last updated Oct 15, 2008
Key facts
- NPI
- 1790977759
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 31962 (NC)
- Practice address
- 152 E Ivybridge Dr
104
Hubert, NC 28539-4462 - Phone
- (910) 219-1339
- NPI assigned
- Aug 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31962 | NC | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 31962 | NC | Yes |
Addresses
Primary practice location
152 E Ivybridge Dr
104
Hubert, NC 28539-4462
Mailing address
152 E Ivybridge Dr
Hubert, NC 28539-4462
Phone (252) 646-3338
Other providers in Hubert, NC
- Cynthia E Bills
- Tamela Joan Bryan
- Melissa Buckalew
- Burklo Home, Inc
- Tiffany Rita-Jane Burnett
- Callie Kay Byron
All providers in Hubert, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.