Individual provider · NPI-1

Kathleen Tomczyk Boetcher, P.A.

Physician Assistant · Bowie, MD

NPI number1053523480
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1053523480
Entity type
Individual (NPI-1)
Name
Kathleen Tomczyk Boetcher
Credential
P.A.
Sex
Female
Sole proprietor
No
Enumeration date
May 6, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantC0000456MDYes

Practice location

14300 Gallant Fox Ln
Suite 118
Bowie, MD 20715-4003

Phone 301-464-3020

Mailing address

14300 Gallant Fox Ln
Suite 118
Bowie, MD 20715-4003

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