Healthcare Provider Details

I. General information

NPI: 1154458867
Provider Name (Legal Business Name): ADAM HAIM BOLDT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 COLUMBUS BLVD STE 403
HARTFORD CT
06106-1976
US

IV. Provider business mailing address

10 COLUMBUS BLVD STE 403
HARTFORD CT
06106-1976
US

V. Phone/Fax

Practice location:
  • Phone: 860-837-7250
  • Fax:
Mailing address:
  • Phone: 860-837-7250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD037381
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOP60663438
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberH0067778
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number063173
License Number StateGA
# 5
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number84652
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW0875
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: