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Individual

ELIA BOLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
CARILION CLINIC ROANOKE MEMORIAL HOSPITAL, 1906 BELLEVIEW AVE,, ROANOKE, VA 24014
(540) 981-7000
Mailing address
6736 MALLARD LAKE DR, ROANOKE, VA 24018-6931
(540) 855-1169

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0116029797
VA

Other

Enumeration date
08/26/2016
Last updated
08/26/2016
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