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Organization
TRIHEALTH
Active
Organization
TRIHEALTH
Active
Other names
Bethesda Family Medicine Residency
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE L BOLDEN MD (RESIDENT)
(513) 631-0763
Entity
Organization
Contact information
Practice address
4411 MONTGOMERY RD, #206, CINCINNATI, OH 45212-3187
(513) 631-0763
Mailing address
4411 MONTGOMERY RD, #206, CINCINNATI, OH 45212-3187
(513) 631-0763
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57010437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57010437
MD TRAINING CERTIFICATE
OH
Enumeration date
06/13/2007
Last updated
08/22/2020
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