Shelley Boehm Mattia Md,Adult Psychiatry, Llc

LBN: Shelley Boehm Mattia Md,Adult Psychiatry, Llc
Shelley Boehm Mattia Md,Adult Psychiatry, Llc is an health care organization with primary practice located at 428 Doty St , Green Bay WI 54301-4509. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adult Mental Health, which is considered as the primary health care specialty. Shelley Boehm Mattia Md,Adult Psychiatry, Llc can be contacted via phone (920) 965-6768, or through Boehm Mattia, Shelley Kathryn via phone (920) 246-4925.

Contact Information

Primary practice address
428 Doty St Green Bay WI 54301-4509
Fax: (920) 965-6769
Website:
Authorized official contact:
Name: Boehm Mattia, Shelley Kathryn Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X 39641 Wisconsin

Profile Details

NPI number 1427410992
LBN Legal business name Shelley Boehm Mattia Md,Adult Psychiatry, Llc
DBA Doing business as
Authorized official Boehm Mattia, Shelley Kathryn Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 24th, 2016
Last updated Oct 4th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427410992 NPPES
Wisconsin MEDICAID 32453500

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