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Individual
MRS. THERES J BOLUS
Active
Individual
MRS. THERES J BOLUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
00015368
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005455043
AETNA
—
05
—
009900345
—
AL
01
—
12-10895
UNITED HEALTH
—
01
—
51510529
BLUE CROSS
—
01
—
E80654
HEALTH SPRING
—
Enumeration date
06/22/2006
Last updated
06/12/2012
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