MEDICARE: JOHN MICHAEL BOLDS MD

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	207RS0012X	Sleep Medicine (Internal Medicine) Physician	14099	TN
2	207RP1001X	Pulmonary Disease Physician	14099	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110054559	OTHER	TN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4082465	OTHER	TN	AETNA
4	2003904	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1659375467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN MICHAEL BOLDS MD

Provider Business Mailing Address
First Line	:	300 20TH AVE N
Second Line	:	9TH FLOOR
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2131
Country	:	US
Telephone Number	:	615-284-1400
Fax Number	:	615-284-1348

Provider Business Practice Location Address
First Line	:	300 20TH AVE N
Second Line	:	9TH FLOOR
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2131
Country	:	US
Telephone Number	:	615-284-1400
Fax Number	:	615-284-1348

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	10/15/2014

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Directions to “ JOHN MICHAEL BOLDS MD” Practice Location

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