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NPI Code Detail

MEDICARE: DR. TINA MONIQUE BOLEK M.D,

MEDICARE: DR. TINA MONIQUE BOLEK M.D,
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
12085R0202XDiagnostic Radiology Physician35.091294OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821261223
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TINA MONIQUE BOLEK M.D,
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line : DESK A-10
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-6348
Fax Number : 216-445-1654
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line : DESK A-10
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-445-6348
Fax Number : 216-445-1654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2008
Last Update Date : 03/11/2026

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