Bolden, Brian Eric
Bolden, Brian Eric is an individual health care provider with primary practice located at 1000 E Mountain Blvd , Wilkes Barre PA 18711-0027. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Bolden, Brian Eric can be contacted via phone (570) 808-7399.Contact Information
Primary practice address
1000 E Mountain Blvd
Wilkes Barre PA 18711-0027
Phone: (570) 808-7399
Fax: (570) 808-5942
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD423426 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD423426 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207RH0002X | MD423426 | Pennsylvania |
Profile Details
| NPI number | 1700846722 |
|---|---|
| LBN Legal business name | Bolden, Brian Eric |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Jul 29th, 2020 - about 6 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 | 1700846722 | NPPES |
| Pennsylvania | Other | 867633 | MEDICARE GROUP # |
| Pennsylvania | MEDICAID | 100000222 0003 0004 | MEDICARE GROUP # |
| Pennsylvania | Other | 001582999 | MEDICARE GROUP # |
| Pennsylvania | Other | 1007307260034 | MEDICARE GROUP # |
| Pennsylvania | MEDICAID | 1010002220001 | MEDICARE GROUP # |
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