Individual
DR. PATRICIA JEAN BOLSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 469-6800
Mailing address
1066 EXECUTIVE PARKWAY DR, SUITE 205, SAINT LOUIS, MO 63141-6340
(314) 469-6800
(314) 469-6803
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
109504
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1499
BCBS
—
05
—
208115410
—
MO
01
—
431170100
TAX ID
—
Enumeration date
05/09/2006
Last updated
11/20/2008
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