Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marie Vale Boomer, PA-C

Individual provider Medical Physician Assistant · NPI 1164621009

Marie Vale Boomer, PA-C is a Medical Physician Assistant in Novi, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

28455 Haggerty Rd Ste 200
Novi, MI 48377-2982
Phone: (248) 893-3200
Fax: (248) 893-2950
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601001569 (MI)

Record details

NPI number1164621009
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 12, 2007
Last updated in NPPESDecember 29, 2015

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