Individual
KELLE DANIELLE BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11 ATRIUM RIDGE CT, COLUMBIA, SC 29223-6438
(803) 699-9992
(803) 865-7429
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29209
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292098
—
SC
Enumeration date
07/20/2006
Last updated
12/05/2016
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