Individual
SIDNEY JEFFERSON BOLCH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1326 EISENHOWER DR, BLDG. 2, SAVANNAH, GA 31406-3928
(912) 527-5300
(912) 527-5149
Mailing address
1326 EISENHOWER DR, BLDG. 2, SAVANNAH, GA 31406-3928
(912) 527-5300
(912) 527-5149
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
016876
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000176712AA
—
GA
05
—
000176712C
—
GA
05
—
000176712R
—
GA
05
—
000176712Z
—
GA
05
—
000932412A
—
GA
05
—
000932412B
—
GA
01
—
060065859
RR MEDICARE
GA
01
—
082552
BCBS
GA
05
—
G16876
—
SC
Enumeration date
07/13/2005
Last updated
06/25/2008
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