Individual
DR. E. LUKE BOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7580 AUBURN ROAD, #103, PAINESVILLE, OH 44077
(440) 352-1474
(440) 352-2662
Mailing address
7580 AUBURN ROAD, #103, PAINESVILLE, OH 44077
(440) 352-1474
(440) 352-2662
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35-060315
OH
207Y00000X
Otolaryngology Physician
Primary
35-060315
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000133452
ANTHEM
OH
01
—
040006752
TRAVELERS RAILROAD MEDICA
OH
05
—
0878153
—
OH
01
—
104632
KAISER
OH
01
—
3415313198A13
BCBS
OH
01
—
71405
QUALCHOICE
OH
Enumeration date
01/25/2006
Last updated
01/15/2021
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