Basic Information
Provider Information
NPI: 1699902130
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOYER
FirstName: DANIEL
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 SOUTH STATE STREET
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 EAST MEDICAL CENTER DR
Address2: 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
City: ANN ARBOR
State: MI
PostalCode: 481095054
CountryCode: US
TelephoneNumber: 8008627284
FaxNumber: 7346152964
Other Information
ProviderEnumerationDate: 06/11/2009
LastUpdateDate: 11/25/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XL-240264MAN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0102X4301104136MIN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0101X4301104136MIY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
207ZH0000X4301104136MIN Allopathic & Osteopathic PhysiciansPathologyHematology

No ID Information.


Home