Ricky Boldman
Ricky Boldman is a Physician Assistant in Pontiac, Michigan. Licensed in Michigan. Registered with an NPI since 2006.
- Licensed in
- MI
- In the registry since
- 2006
Practice location Address checks out
461 W Huron St Ste 207Pontiac, MI 48341-1601
Phone: (248) 857-7160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 5601001019 (MI) |
|---|
Record details
| NPI number | 1437126323 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 1, 2006 |
| Last updated in NPPES | July 16, 2007 |
| Mailing address | 461 W Huron St, Suite 207, Pontiac, MI 48341-1601 |
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