Provider Demographics
NPI:1578743860
Name:BOYCE, CHRISTOPHER GEORGE (IDC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:GEORGE
Last Name:BOYCE
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMSUBRON 15
Mailing Address - Street 2:
Mailing Address - City:SANTA RITA
Mailing Address - State:GUAM
Mailing Address - Zip Code:96915
Mailing Address - Country:UM
Mailing Address - Phone:671-777-9343
Mailing Address - Fax:
Practice Address - Street 1:COMSUBRON 15
Practice Address - Street 2:
Practice Address - City:SANTA RITA
Practice Address - State:GUAM
Practice Address - Zip Code:96915
Practice Address - Country:UM
Practice Address - Phone:671-777-9343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman