Individual
MS. MARY ELIZABETH BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1 S MAIN ST, SUITE 1, CHAGRIN FALLS, OH 44022-3225
(440) 893-8800
(440) 893-9422
Mailing address
1 S MAIN ST, SUITE 1, CHAGRIN FALLS, OH 44022-3225
(440) 893-8800
(440) 893-9422
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36 002693
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050343
ANTHEM
KY
01
—
1218328
CHA HEALTH
—
01
—
480032480
RAILROAD MEDICARE
KY
01
—
611341106
UNITED
—
Enumeration date
08/12/2005
Last updated
07/01/2014
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