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Individual

DR. DANIEL LEROY BOHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
76 CAMPANELLI INDUSTRIAL DR, BROCKTON, MA 02301-1809
(508) 930-3062
(508) 587-0287
Mailing address
76 CAMPANELLI INDUSTRIAL DR, BROCKTON, MA 02301-1809
(508) 930-3062
(508) 587-0287

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
200202484
MO
207RN0300X
Nephrology Physician
Primary
235028
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202912
MO-BLUE SHIELD
Enumeration date
07/14/2006
Last updated
04/10/2024
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