Provider Demographics
NPI:1659469195
Name:BOYES, DANIEL E (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:E
Last Name:BOYES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 118
Mailing Address - Street 2:
Mailing Address - City:RIEGELWOOD
Mailing Address - State:NC
Mailing Address - Zip Code:28456-0118
Mailing Address - Country:US
Mailing Address - Phone:910-655-0021
Mailing Address - Fax:910-655-2777
Practice Address - Street 1:210 HIGHWAY 87
Practice Address - Street 2:
Practice Address - City:RIEGELWOOD
Practice Address - State:NC
Practice Address - Zip Code:28456-0118
Practice Address - Country:US
Practice Address - Phone:910-655-0021
Practice Address - Fax:910-655-2777
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000100868363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical