Individual
SHANNON MARIE BOLTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST # N5W70, BALTIMORE, MD 21201-1544
(410) 328-6960
(410) 328-0646
Mailing address
22 S GREENE ST # N5W70, BALTIMORE, MD 21201-1544
(410) 328-6960
(410) 328-0646
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0099725
MD
Other
Enumeration date
04/02/2021
Last updated
05/09/2024
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