Individual provider · Type 1 NPI
David Alden Boedeker, PA-C
Medical Physician Assistant · Lansing, MI
NPI number
1508311085
Active
Practice location
2815 S. Pennsylvania Ave, Suite 204
Lansing, MI 48910-3496
Fax (517) 267-1877
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5601008520 (MI) |
| Medical Physician Assistant Primary | 363AM0700X | PT696 (WY) |
Medical Physician Assistant: Definition to come...
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About NPI 1508311085
David Alden Boedeker, PA-C's National Provider Identifier is 1508311085, issued on Aug 24, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lansing, MI. The record was last updated on Oct 4, 2021.