Individual
RUTH BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 883-1000
Mailing address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 883-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28107
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42A51BO
BLUE CROSS BLUE SHIELD
MN
Enumeration date
07/19/2006
Last updated
03/30/2018
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