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1881647014 NPI number — RHONDA R BOLDT MD

NPI Number: 1881647014
Health Care Provider/Practitioner: RHONDA R BOLDT MD

Information about “1881647014” NPI (RHONDA R BOLDT MD) exists in 1881647014 in HTML format HTML  |  1881647014 in plain Text format TXT  |  1881647014 in PDF (Portable Document Format) PDF  |  1881647014 in an XML format XML  formats.

NPI Number : 1881647014 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1881647014",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BOLDT",
    "FirstName": "RHONDA",
    "MiddleName": "R",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FISCHER",
    "OtherFirstName": "RHONDA",
    "OtherMiddleName": "RAE BOLDT",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "2524 E WEBSTER PL",
    "SecondLineMailingAddress": "STE 301",
    "MailingAddressCityName": "MILWAUKEE",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53211-4256",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "414-272-7009",
    "MailingAddressFaxNumber": "414-272-6261",
    "FirstLinePracticeLocationAddress": "2524 E WEBSTER PL",
    "SecondLinePracticeLocationAddress": "STE 301",
    "PracticeLocationAddressCityName": "MILWAUKEE",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53211-4256",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "414-272-7009",
    "PracticeLocationAddressFaxNumber": "414-272-6261",
    "EnumerationDate": "05/18/2006",
    "LastUpdateDate": "01/18/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208000000X",
        "TaxonomyName": "Pediatrics Physician",
        "LicenseNumber": "29408",
        "LicenseNumberStateCode": "WI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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