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Individual

JAMES EDWIN BOLANDER II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5510 S EAST ST STE H, INDIANAPOLIS, IN 46227-1939
(317) 924-8425
(317) 924-8424
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 573-5000
(317) 882-2873

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
01039451
IN
207RN0300X
Nephrology Physician
Primary
01039451A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000083029
ANTHEM NUMBER
IN
05
200026630
IN
Enumeration date
07/07/2005
Last updated
11/29/2022
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