Provider Demographics
NPI:1447233267
Name:BOYER, JAMES LORENZEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LORENZEN
Last Name:BOYER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 98019, 333 CEDAR ST, 1080 LMP
Mailing Address - Street 2:YALE UNIVERSITY SHOOL OF MEDICINE, SECTION OF DIGESTIVE
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8019
Mailing Address - Country:US
Mailing Address - Phone:203-785-7352
Mailing Address - Fax:203-785-7273
Practice Address - Street 1:40 TEMPLE ST., SUITE 1A
Practice Address - Street 2:TEMPLE MEDICAL CENTER
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-785-4138
Practice Address - Fax:203-785-6414
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT012702207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001127026Medicaid
CT1121026Medicaid
CT110001657Medicare ID - Type Unspecified
CT001127026Medicaid