MEDICARE: SAMUEL F. BOLES, MD P.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1013763697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMUEL F. BOLES, MD P.C

Provider Business Mailing Address
First Line	:	PO BOX 15659
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4051
Country	:	US
Telephone Number	:	410-224-2010
Fax Number	:

Provider Business Practice Location Address
First Line	:	127 LUBRANO DR STE 301
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7560
Country	:	US
Telephone Number	:	410-224-2010
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAMUEL FRANK BOLES
Credential	:	MD
Telephone Number	:	410-224-2010

Provider Enumeration Date	:	04/25/2024
Last Update Date	:	04/25/2024

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