Healthcare Provider Details

I. General information

NPI: 1730214487
Provider Name (Legal Business Name): JAMES BOLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8820 AMERICAN WAY # 201
ENGLEWOOD CO
80112-7056
US

IV. Provider business mailing address

8820 AMERICAN WAY # 201
ENGLEWOOD CO
80112-7056
US

V. Phone/Fax

Practice location:
  • Phone: 720-873-8730
  • Fax: 720-873-8732
Mailing address:
  • Phone: 720-873-8730
  • Fax: 720-873-8732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number26796
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: