Healthcare Provider Details

I. General information

NPI: 1013908219
Provider Name (Legal Business Name): ARTHUR L BOLAND JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 CAMBRIDGE ST STE 400
BOSTON MA
02114-2797
US

IV. Provider business mailing address

175 CAMBRIDGE ST STE 400
BOSTON MA
02114-2797
US

V. Phone/Fax

Practice location:
  • Phone: 617-643-2259
  • Fax: 617-726-3438
Mailing address:
  • Phone: 617-643-2259
  • Fax: 617-726-3438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number31055
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: