Individual
KEITH C BOLDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
435 LEWIS AVE, MERIDEN, CT 06451-2101
(203) 694-8200
Mailing address
391 BROAD ST, MERIDEN, CT 06450-5844
(203) 238-1555
(203) 634-0533
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
043896
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316126444
—
CT
Enumeration date
10/25/2007
Last updated
06/23/2008
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