Provider Demographics
NPI:1134313638
Name:BOEHMER, BLAIR EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:EDWARD
Last Name:BOEHMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:421 CANAL VIEW CIR
Mailing Address - Street 2:APT K
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-6141
Mailing Address - Country:US
Mailing Address - Phone:317-844-6269
Mailing Address - Fax:317-815-7567
Practice Address - Street 1:10610 N PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-2004
Practice Address - Country:US
Practice Address - Phone:317-844-6269
Practice Address - Fax:317-815-7567
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2011-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01069880A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology