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Individual

ROBERT DEANE BOLTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
701 HOSPITAL LOOP, FAIRCHILD AFB, WA 99011-8704
(509) 247-9043
Mailing address
LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100, APO, AE 09180-3100
(314) 590-7700

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
1063738631
IN
208000000X
Pediatrics Physician
Primary
MD2013-0296
NM

Other

Enumeration date
04/07/2010
Last updated
08/11/2023
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