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General NPI Number Information
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NPI Number | 1699733782
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Entity Type | Individual
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Provider Name | GREGORY C BOLTON JR. MD
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 100 MARKET STREEET SUITE 300
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-4927
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Country | US
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Telephone | 412-599-1039
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Fax | 412-599-1035
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Provider Business Mailing Address
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Address Line | PO BOX 195
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City | SKIPPACK
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State | PA
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Zip | 19474-0195
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Country | US
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Telephone | 412-599-1039
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Fax | 412-599-1035
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD060356L
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License Number State | PA
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