Individual
DR. MICHAEL J BOULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
419 5TH ST NE, JAMESTOWN, ND 58401-3300
(701) 253-4855
(701) 253-4815
Mailing address
PO BOX 1917, WILLISTON, ND 58802-1917
(701) 770-1238
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5338
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15405
—
ND
Enumeration date
07/07/2006
Last updated
07/08/2007
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