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Individual
MARY D BOLT
Active
Individual
MARY D BOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000086
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540C312880
BCBS HEARING AIDS
MI
01
—
640C326130
BCBS SERVICES
MI
05
—
804679861
—
MI
Enumeration date
08/13/2006
Last updated
05/27/2014
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