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Contact Information

PETER BOOTHMAN, M.D.
1618 S MILLENIUM WAY STE 100
MERIDIAN, ID83642-6457
 Phone: 208-884-3376
 Fax: 208-884-0858
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for PETER BOOTHMAN · (Male)

NPI Number 1588018170
Status Active
Credentials M.D.
Entity Individual
Enumeration date 04/20/2016
Last updated 05/18/2026 - About 3 weeks ago
Sole proprietor 1 Yes
Identifiers
  • AL License # MD.36224
  • ID License # M-17515
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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