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Individual

DR. NATHAN D BOLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 864-8454
(228) 865-1451
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 864-8454
(228) 865-1451

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19325
MS
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
19325
MS
208M00000X
Hospitalist Physician
Primary
19325
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09952743
MS
Enumeration date
10/11/2006
Last updated
08/10/2023
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