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Individual

DR. TIMOTHY BOLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 S 2ND ST STE 4B, HARRISBURG, PA 17101-2546
(717) 231-8472
(717) 231-8490
Mailing address
100 S 2ND ST STE 4B, HARRISBURG, PA 17101-2546

Taxonomy

Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
MD426303
PA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD426303
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000169311
GATEWAY
PA
01
001740376
HIGHMARK
PA
05
101301146
PA
01
1086483
AETNA-HMO
PA
01
2407344000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
02/26/2006
Last updated
01/18/2021
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