Boom, Ralph Ried

Boom, Ralph Ried is an individual health care provider with primary practice located at 709 W Main St , Manchester IA 52057-1526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Boom, Ralph Ried can be contacted via phone (563) 927-7985.

Contact Information

Primary practice address
709 W Main St Manchester IA 52057-1526
Phone: (563) 927-7985
Fax: (563) 927-7934
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22897 Iowa

Profile Details

NPI number 1720086275
LBN Legal business name Boom, Ralph Ried
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Oct 28th, 2020 - about 6 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 1720086275 NPPES
Iowa MEDICAID 0210831

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