Provider Demographics
NPI:1740286509
Name:BOERSMA, CAROL A (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:BOERSMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:900 RIO EAST CT
Mailing Address - Street 2:STE A
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8040
Mailing Address - Country:US
Mailing Address - Phone:434-975-7777
Mailing Address - Fax:434-975-7774
Practice Address - Street 1:900 RIO EAST CT
Practice Address - Street 2:STE A
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8040
Practice Address - Country:US
Practice Address - Phone:434-975-7777
Practice Address - Fax:434-975-7774
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2020-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238260208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics