Boltan, David Dmitry
Boltan, David Dmitry is an individual health care provider with primary practice located at 1901 N Macarthur Blvd , Irving TX 75061-2220. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Boltan, David Dmitry can be contacted via phone (972) 579-8485.Contact Information
Primary practice address
1901 N Macarthur Blvd
Irving TX 75061-2220
Phone: (972) 579-8485
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | M8543 | Texas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | M8543 | Texas |
Profile Details
| NPI number | 1447468624 |
|---|---|
| LBN Legal business name | Boltan, David Dmitry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2007 |
| Last updated | Apr 2nd, 2010 - about 15 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 | 1447468624 | NPPES |
| Texas | Other | 8X0058 | BCBS |
| Texas | MEDICAID | 200691801 | BCBS |
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