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Individual

JOHN W BOLEN

Active
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Individual

JOHN W BOLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
MD00016100
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0039575
LABOR & INDUSTRY
WA
01
220013529
RAILROAD MEDICARE
01
804194900
IDAHO MEDICAID
WA
05
8381204
WA
01
B460
BLUE SHIELD
WA
01
MD6100W
ALASKA MEDICAID
WA
01
US0861403
AETNA/USHC SPECIALIST
WA
Enumeration date
07/13/2006
Last updated
06/17/2008
Update your record

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