Individual
DR. PRAVEEN K BOLARUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
196 THOMAS JOHNSON DR STE 135, FREDERICK, MD 21702
(301) 694-6688
(301) 694-8524
Mailing address
196 THOMAS JOHNSON DR STE 135, FREDERICK, MD 21702-4518
(301) 694-6688
(301) 694-8524
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0062223
MD
Other
Enumeration date
04/05/2006
Last updated
06/12/2018
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