Individual
DR. DOUGLAS BOLDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1263 HOSPITAL DR NW STE 105, CORYDON, IN 47112-2173
(812) 738-4251
Mailing address
PO BOX 38, CORYDON, IN 47112-0038
(812) 738-4251
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01048624A
IN
207X00000X
Orthopaedic Surgery Physician
77087
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000391438
ANTHEM, BCBS
IN
05
—
1174519458
—
WI
05
—
200804530
—
IN
Enumeration date
09/22/2005
Last updated
01/20/2025
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