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General NPI Number Information
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NPI Number | 1346212750
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Entity Type | Individual
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Provider Name | SUSAN ELAINE BOLDYS MD
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Gender | Female
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 950 W WOOSTER ST WOOD COUNTY HOSPITAL
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2603
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Country | US
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Telephone | 419-354-8977
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Fax | 419-373-4157
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Provider Business Mailing Address
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Address Line | 5650 W CENTRAL AVE STE D
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City | TOLEDO
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State | OH
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Zip | 43615-1510
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Country | US
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Telephone | 419-534-2888
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Fax | 419-534-2898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 35045449B
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License Number State | OH
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