Provider Demographics
NPI:1255696092
Name:BOVEN, DOUGLAS JOSEPH II (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:JOSEPH
Last Name:BOVEN
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:30701 BARRINGTON ST STE 150
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-5135
Mailing Address - Country:US
Mailing Address - Phone:248-616-1170
Mailing Address - Fax:248-589-9872
Practice Address - Street 1:3535 W 13 MILE RD STE 437
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6770
Practice Address - Country:US
Practice Address - Phone:248-288-2210
Practice Address - Fax:248-589-9875
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2022-07-28
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Provider Licenses
StateLicense IDTaxonomies
MI4301101231208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation