Individual
DR. GEROME VALLADOLID BOLALIN
Active
Individual
DR. GEROME VALLADOLID BOLALIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01074664A
IN
207R00000X
Internal Medicine Physician
Primary
MD60819263
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000976632
ANTHEM (REID PHYSICIAN ASSOCIATES, INC.)
—
05
—
0121786
—
OH
05
—
201305950
—
IN
05
—
2113646
—
WA
Enumeration date
07/09/2012
Last updated
12/01/2020
Update your record
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