Bolda, Douglas

Bolda, Douglas is an individual health care provider with primary practice located at 3500 Franciscan Way , Michigan City IN 46360-0021. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Bolda, Douglas can be contacted via phone (219) 879-8511.

Contact Information

Primary practice address
3500 Franciscan Way Michigan City IN 46360-0021
Phone: (219) 879-8511
Fax: (219) 933-2288
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 77087 Wisconsin
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 01048624A Indiana

Profile Details

NPI number 1174519458
LBN Legal business name Bolda, Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Mar 21st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174519458 NPPES
Wisconsin MEDICAID 1174519458
Wisconsin MEDICAID 200804530
Wisconsin Other 000000391438

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