Boertje, Douglas Lee
Boertje, Douglas Lee is an individual health care provider with primary practice located at 501 S Sharon Amity Rd Ste 300 , Charlotte NC 28211-0035. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as his primary health care specialty. Boertje, Douglas Lee can be contacted via phone (704) 377-2424.Contact Information
Primary practice address
501 S Sharon Amity Rd Ste 300
Charlotte NC 28211-0035
Phone: (704) 377-2424
Fax: (704) 377-2687
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | 2006-01516 | North Carolina |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | 36257 | Tennessee |
Profile Details
| NPI number | 1558361246 |
|---|---|
| LBN Legal business name | Boertje, Douglas Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2005 |
| Last updated | Aug 23rd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558361246 | NPPES |
| South Carolina | Other | N01517 | SC MEDICAID |
| South Carolina | MEDICAID | 59-05661 | SC MEDICAID |
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