Individual
TYLER BOLD
Active
Individual
TYLER BOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
255586
MA
207RI0200X
Infectious Disease Physician
265066
MA
207RI0200X
Infectious Disease Physician
Primary
64452
MN
Other
Enumeration date
06/06/2013
Last updated
09/18/2018
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