Individual
DR. MARK ALAN BOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1331 NORTH ELM STREET, SUITE 200, GREENSBORO, NC 27401-6304
(336) 274-9617
(336) 482-2177
Mailing address
PO BOX 63112, CHARLOTTE, NC 28263-3112
(336) 274-9617
(336) 482-2177
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
9700867
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049U
BLUE CROSS BLUE SHIELD
NC
01
—
1603211
UNITED HEALTHCARE
NC
01
—
24726
PARTNERS
NC
01
—
300085676
RAILROAD MEDICARE
NC
01
—
70567
MEDCOST
NC
05
—
891049U
—
NC
Enumeration date
10/28/2005
Last updated
03/10/2023
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