Provider Demographics
NPI:1942235619
Name:BOILEAU, ANNE M (DO)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:BOILEAU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1011 ARTHUR STREET
Mailing Address - Street 2:P O BOX 2027
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52244-2027
Mailing Address - Country:US
Mailing Address - Phone:319-339-3541
Mailing Address - Fax:319-358-2737
Practice Address - Street 1:269 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-3616
Practice Address - Country:US
Practice Address - Phone:319-351-6852
Practice Address - Fax:319-351-2625
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA3515207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4428052Medicaid
IA3428052Medicaid
IA39440OtherBRITT CLINIC WELLMARK
IA39441OtherGARNER WELLMARK
IA5428052Medicaid
IA4428052Medicaid