Individual
GINGER BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 MEDICAL CENTER DRIVE, CLARKBURG, WV 26301
(304) 623-3461
Mailing address
1 MEDICAL CENTER DRIVE, CLARKSBURG, WV 26301
(304) 623-3461
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00391
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718071
WV BCBS
WV
01
—
1066361
WV DWC
WV
Enumeration date
12/19/2005
Last updated
06/03/2013
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