Individual
MARY BETH BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2850 W GRAND BLVD, DETROIT, MI 48202-2643
(313) 664-8361
(313) 664-8433
Mailing address
21706 CHASE DR, NOVI, MI 48375-4766
(313) 664-8361
(313) 664-8433
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301048472
MI
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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