Individual
MICHAEL J BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
255 BAPTIST BLVD, SUITE 402, COLUMBUS, MS 39705
(662) 240-1412
(662) 240-1949
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827
(901) 227-4068
(901) 227-4051
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
00027291
AL
207RC0000X
Cardiovascular Disease Physician
056686
GA
207RC0000X
Cardiovascular Disease Physician
Primary
06387
MS
207RC0000X
Cardiovascular Disease Physician
6387
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009601740
—
AL
05
—
0115039
—
MS
01
—
730-01754
BLUE CROSS BLUE SHIELD
AL
01
—
730-05844
BLUE CROSS BLUE SHIELD
AL
01
—
730-05954
BLUE CROSS BLUE SHIELD
AL
01
—
730-73298
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/10/2006
Last updated
12/07/2012
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