Basic Information
| Provider Information | |||||||||
| NPI: | 1396009098 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOYD | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | AUGUST | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 E. MEDICAL CENTER DR. | ||||||||
| Address2: | B1-380 TC, SPC 5305 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347637919 | ||||||||
| FaxNumber: | 7347639298 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 DUTCH RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | BEAVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150099727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247287000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2012 | ||||||||
| LastUpdateDate: | 07/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301101003 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD457931 | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.