Individual
EDGAR B BOLTON JR.
Active
Individual
EDGAR B BOLTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
OS2458
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037708200
—
FL
01
—
HF850A
MEDICARE PTAN
FL
Enumeration date
11/08/2005
Last updated
02/11/2016
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