Provider Demographics
NPI:1013969930
Name:BOYNTON, CYNTHIA S (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:S
Last Name:BOYNTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1540 LAKE LANSING RD
Mailing Address - Street 2:STE 201
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-3900
Mailing Address - Fax:517-913-3901
Practice Address - Street 1:1540 LAKE LANSING RD
Practice Address - Street 2:STE 201
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3756
Practice Address - Country:US
Practice Address - Phone:517-913-3900
Practice Address - Fax:517-913-3901
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301057923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200000001279OtherPHP
MI383267121OtherPPOM
MI4501208OtherAETNA
MI1001278OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI381916OtherPHCS
MI1001278OtherMCLAREN HEALTH PLAN-MEDICAID
MI0M21440013OtherMEDICARE PLUS BLUE
MI4848131Medicaid
MI1001278OtherMCLAREN HEALTH ADVANTAGE
MI110184723OtherRAILROAD MEDICARE
MI4083558Medicaid
MI1103308831OtherBCBS/BCN
MI200000001279OtherPHP FAMILYCARE
MI200000001279OtherPHP
MIM21440013Medicare PIN