Provider Demographics
NPI:1215022769
Name:BOEHME, WILLIAM M (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:BOEHME
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:350 HERITAGE WAY
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-752-8900
Mailing Address - Fax:406-752-8909
Practice Address - Street 1:350 HERITAGE WAY
Practice Address - Street 2:SUITE 1100
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-752-8900
Practice Address - Fax:406-752-8909
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT4056207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0018768Medicaid
MT000081093Medicare ID - Type Unspecified
MT0018768Medicaid