Ralph Morton Bolman III, MD

Individual provider Active NPI Surgery Physician · Burlington, VT

NPI 1043201510 · NPPES record last updated Jun 25, 2015

Key facts

NPI
1043201510
Entity type
Individual (NPI type 1)
Primary specialty
Surgery Physician 208600000X
License
042.0013180 (VT)
Practice address
111 Colchester Ave.
Uvm Medical Center - CT Surgery
Burlington, VT 05401
Phone
(802) 847-4044
Fax
(802) 847-8158
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 224180 MA
Surgery Physician 208600000X 042.0013180 VT Yes

Addresses

Primary practice location

111 Colchester Ave.
Uvm Medical Center - CT Surgery
Burlington, VT 05401

Mailing address

111 Colchester Ave.
Uvm Medical Center - CT Surgery
Burlington, VT 05401
Phone (802) 847-4044

Other providers in Burlington, VT

All providers in Burlington, VT · Surgery Physician in Vermont

Sources for this page

Verify at the official NPI Registry.