Individual
MICHAEL K BOHLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 MOUNTAIN VIEW ST, POWELL, WY 82435-2212
(307) 754-7257
(307) 754-7217
Mailing address
449 MOUNTAIN VIEW ST, POWELL, WY 82435-2232
(307) 754-4559
(307) 754-7733
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5478A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106639
MT MEDICAID
MT
01
—
306685
BLUE CROSS BLUE SHIELD
WY
Enumeration date
10/13/2005
Last updated
10/19/2007
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