Provider Demographics
NPI:1205829819
Name:BOARINI, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:BOARINI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9255
Mailing Address - Fax:515-875-9223
Practice Address - Street 1:1215 PLEASANT ST STE 608
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1418
Practice Address - Country:US
Practice Address - Phone:515-875-9560
Practice Address - Fax:515-875-9561
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2023-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAMD-22297207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA01708Medicare UPIN