Individual
DR. MARIA RITA BOLISAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1116 MILLIS AVE, SUITE 101, BOONVILLE, IN 47601-2242
(812) 897-7383
(812) 897-7236
Mailing address
1116 MILLIS AVE, SUITE 101, BOONVILLE, IN 47601-2242
(812) 897-7383
(812) 897-7236
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01047204
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000254914
BLUE CROSS
IN
05
—
200138620
—
IN
Enumeration date
03/25/2006
Last updated
05/04/2023
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