Individual
DR. DANIEL JEFFREY BOULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
395 W 12TH AVE, RM 460, COLUMBUS, OH 43210-1267
(614) 293-8315
(614) 293-6935
Mailing address
395 W 12TH AVE, RM 460, COLUMBUS, OH 43210-1267
(614) 293-8315
(614) 293-6935
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
249788
MA
2085R0202X
Diagnostic Radiology Physician
30836
SC
2085R0202X
Diagnostic Radiology Physician
Primary
35123344
OH
Other
Enumeration date
03/30/2008
Last updated
05/27/2014
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