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Individual
EDWARD STEPHEN BOLESTA
Active
Individual
EDWARD STEPHEN BOLESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
36579
MO
207ZP0101X
Anatomic Pathology Physician
Primary
36579
MO
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
36579
MO
Other
Enumeration date
07/28/2006
Last updated
01/17/2017
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