Provider Demographics
NPI:1255498895
Name:BOAZ, VALERIE A (MD)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:A
Last Name:BOAZ
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:921 EAST THIRD STREET
Mailing Address - Street 2:CHATTANOOGA HAMILTON COUNTY HEALTH DEPARTMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403
Mailing Address - Country:US
Mailing Address - Phone:423-209-8000
Mailing Address - Fax:423-209-8001
Practice Address - Street 1:921 EAST THIRD STREET
Practice Address - Street 2:CHATTANOOGA HAMILTON COUNTY HEALTH DEPARTMENT
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-209-8000
Practice Address - Fax:423-209-8001
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000016844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F77275Medicare UPIN