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NPI Code Detail

MEDICARE: MR. JOSEPH BOLES

MEDICARE:  MR. JOSEPH  BOLES
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
11041C0700XClinical Social WorkerC015463NC

General Provider Information

NPI Number : 1710520044
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH BOLES
Provider Business Mailing Address
First Line : 3980 PREMIER DRIVE SUITE 110 PMB 1039
Second Line :
City : HIGH POINTE
State : NC
Zip : 27265
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3980 PREMIER DR STE 110
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-8409
Country : US
Telephone Number : 336-496-2824
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2019
Last Update Date : 05/13/2024

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Directions to “ MR. JOSEPH BOLES ” Practice Location

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