# DR. THOMAS G BOLDUC

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1487628608
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 0420012746 | VT | Yes |
| 208000000X | Pediatrics Physician | MD00042058 | WA | — |

## Other

- **Enumeration date:** 02/14/2006
- **Last updated:** 03/22/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0420012746 | MEDICAL LICENSE | VT |
| 05 | — | 1022471 | — | VT |
| 01 | — | 172210 | L&I | WA |
| 05 | — | 299829 | — | OR |
| 05 | — | 8364523 | — | WA |
| 01 | — | P00018622 | RAIL ROAD MEDICARE | WA |