Individual
DR. LUIS E BOLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2828 1ST AVE, SUITE 400, HUNTINGTON, WV 25702-1236
(304) 525-6905
(304) 525-4316
Mailing address
2828 1ST AVE, SUITE 400, HUNTINGTON, WV 25702-1236
(304) 525-6905
(304) 525-4316
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
18023
WV
207XS0106X
Orthopaedic Hand Surgery Physician
18023
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0098065000
—
WV
05
—
0915979
—
OH
Enumeration date
04/27/2006
Last updated
10/22/2012
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