Individual
DAVID HENRY BOLONKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2818 GRANT LINE RD, NEW ALBANY, IN 47150-2492
(812) 725-7542
(812) 725-7543
Mailing address
734 W MAIN ST STE 100, LOUISVILLE, KY 40202-3687
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000563
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000942326
ANTHEM
IN
05
—
100075780
—
IN
Enumeration date
07/14/2006
Last updated
04/06/2017
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