IndividualActive
Peter Boothman, M.D.
NPI 1588018170 · MOHS-Micrographic Surgery Physician · Meridian, ID
Provider details
- NPI number
- 1588018170
- Entity type
- Individual
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- M-17515 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1618 S Millenium Way Ste 100
Meridian, ID 83642-6457
Phone: (208) 884-3376
Fax: (208) 884-0858
Approximate (ZIP-level) locationGet directions
Mailing address
1618 S Millenium Way Ste 100
Meridian, ID 83642-6457
Registry dates
- Enumerated
- 2016-04-20
- Last updated
- 2026-05-18
- Certified
- 2026-05-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.