Boden, Stephen Richard

Boden, Stephen Richard is an individual health care provider with primary practice located at 390 N Main St , Bountiful UT 84010-6046. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Allergy & Immunology is his primary health care specialty. Boden, Stephen Richard can be contacted via phone (801) 397-6300.

Contact Information

Primary practice address
390 N Main St Bountiful UT 84010-6046
Phone: (801) 397-6300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 12974480-1205 Utah
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 12974480-1205 Utah

Profile Details

NPI number 1700878691
LBN Legal business name Boden, Stephen Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Mar 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700878691 NPPES
Utah MEDICAID 4128124
Utah Other LD948
Utah MEDICAID 102859200

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