Rebekah Elisabeth-Carradine Boulanger
Internal Medicine in Saint Joseph, MI. Individual provider (NPI-1).
NPI number1942735477
StatusActive
Last updated in NPPESSep 18, 2020
Details
- NPI
- 1942735477
- Entity type
- Individual (NPI-1)
- Name
- Rebekah Elisabeth-Carradine Boulanger
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2017
- Certification date
- Sep 18, 2020
- Last updated
- Sep 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 04785 | KY | Yes |
Other names
- Rebekah Elisabeth-Carradine Boulanger (Professional Name)
Practice location
1234 Napier AveSaint Joseph, MI 49085-2112
Phone 269-983-8300
Mailing address
1234 Napier AveSaint Joseph, MI 49085-2112
Phone 269-983-8300
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