DR. BRIAN MICHAEL BOLDT (NPI# 1144480245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144480245 |
| Entity Type | Individual |
| Full Name | DR. BRIAN MICHAEL BOLDT |
| Credential | D.O. |
| Practice Address |
Madigan Army Medical Ctr Department Of 9040 Fitzsimmons Drive Tacoma WA 98431-0001 |
| Mailing Address |
4455 Logan Dr Ne Lacey WA 98516-1351 |
| Practice Telephone | 2539685604 |
| Mailing Telephone | 2532100412 |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2014-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
OP60104328 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
MADIGAN ARMY MEDICAL CTR DEPARTMENT OF 9040 FITZSIMMONS DRIVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992001820 | Milton Bleiweiss | Radiology | 3110 N Narrows Dr, Tacoma, WA 98407-1516 | 2011-02-10 |
| 1790986461 | Amy Guttmann | Radiology | 1201 Pacific Ave Ste 400, Tacoma, WA 98402-4381 | 2007-05-30 |
| 1316039985 | Jill D Robinson | Radiology | 2326 Browns Point Blvd Ne, Tacoma, WA 98422-2314 | 2006-09-29 |
| 1225065162 | James Hwiyoung Chang | Radiology | 9040 Jackson Ave Madigan Amc, Tacoma, WA 98431-2010 | 2006-06-27 |
| 1881642668 | Alexander Serra | Radiology | 5426 Hyada Blvd Ne, Tacoma, WA 98422-1620 | 2006-05-04 |
| 1992703474 | James A. Nudelman | Radiology | 1304 Fawcett Ave, Suite 100, Tacoma, WA 98402-1911 | 2005-07-08 |
| 1841658598 | Gensuke Akaike | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2016-02-09 |
| 1194115626 | Matthew Grant | Radiology | 9040 Jackson Ave, Tacoma, WA 98431-1000 | 2015-02-04 |
| 1487073979 | Bryce Allen Merritt | Radiology | 1304 Fawcett Ave, Tacoma, WA 98402-1911 | 2014-04-10 |
| 1912325473 | Nicholas Zane Conley | Radiology | 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | 2014-04-02 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.