Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mark A Boomershine, PA

Individual provider Medical Physician Assistant · NPI 1164617122

Mr. Mark A Boomershine, PA is a Medical Physician Assistant in East Lansing, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3496 E Lake Lansing Rd Ste 100
East Lansing, MI 48823-2288
Phone: (517) 333-0968
Fax: (517) 333-4306
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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 5601001393 (MI)

Record details

NPI number1164617122
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 12, 2007
Last updated in NPPESMarch 7, 2023

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