Individual
LYLE G BOHLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 AIRPORT RD SW STE 100, HUNTSVILLE, AL 35802-4304
(256) 429-4809
(256) 429-4163
Mailing address
195 CANAL ST, MALDEN, MA 02148-6701
(781) 338-0500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.37647
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3002501
—
MA
Enumeration date
10/12/2005
Last updated
07/25/2023
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