Provider Demographics
NPI:1376518662
Name:BOYD, ANNE SUSAN (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:SUSAN
Last Name:BOYD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 LUNT RD STE 206
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1996
Mailing Address - Country:US
Mailing Address - Phone:207-506-0301
Mailing Address - Fax:207-987-4022
Practice Address - Street 1:74 LUNT RD STE 206
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1996
Practice Address - Country:US
Practice Address - Phone:207-506-0301
Practice Address - Fax:207-987-4022
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9939207Q00000X
CAC50851207QS0010X, 207Q00000X
MEMD27757207Q00000X, 207QS0010X
PAMD423177207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100944310Medicaid
PA080634Medicare ID - Type Unspecified
G47625Medicare UPIN