Individual
JOHN D. BOLDIZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1333 S DICKINSON DR UNIT 140, LELAND, NC 28451-6434
(910) 662-6600
(910) 550-3787
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 686-2525
(910) 686-1606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200300562
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235179482
—
NC
05
—
89134PU
—
NC
Enumeration date
06/07/2006
Last updated
03/18/2025
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