Individual
DR. PRESTON BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
80105
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015222
—
MS
01
—
P00391905
MEDICARE RAILROAD
MS
Enumeration date
03/17/2006
Last updated
04/02/2008
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