Bolduc, Diane
Bolduc, Diane is an sole proprietor health care provider with primary practice located at 340 Medical Loop , Roseburg OR 97470-1645. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bolduc, Diane can be contacted via phone (541) 464-5907.Contact Information
Primary practice address
340 Medical Loop
Roseburg OR 97470-1645
Phone: (541) 464-5907
Fax: (541) 464-8481
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD23487 | Oregon |
Profile Details
| NPI number | 1174537047 |
|---|---|
| LBN Legal business name | Bolduc, Diane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174537047 | NPPES |
| Oregon | MEDICAID | 287185 | |
| Oregon | Other | 840254000 | |
| Oregon | Other | J103601 | |
| Oregon | Other | 32945700000 | |
| Oregon | Other | 608828900 |
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