E. Luke Bold, M.D.
Individual provider Active NPI Otolaryngology Physician · Painesville, OH
NPI 1366412827 · NPPES record last updated Jan 15, 2021
Key facts
- NPI
- 1366412827
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 35-060315 (OH)
- Practice address
- 7580 Auburn Road
#103
Painesville, OH 44077 - Phone
- (440) 352-1474
- Fax
- (440) 352-2662
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-060315 | OH | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastside Hearing Aid Center, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 35-060315 | OH | |
| Otolaryngology Physician | 207Y00000X | 35-060315 | OH | Yes |
Addresses
Primary practice location
7580 Auburn Road
#103
Painesville, OH 44077
Mailing address
7580 Auburn Road
#103
Painesville, OH 44077
Phone (440) 352-1474
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000133452 | Other | OH | ANTHEM |
| 104632 | Other | OH | KAISER |
| 040006752 | Other | OH | TRAVELERS RAILROAD MEDICA |
| 0878153 | Medicaid | OH | |
| 3415313198A13 | Other | OH | BCBS |
| 71405 | Other | OH | QUALCHOICE |
Other names
- E. Luke Bold
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ebold@uhps.allscriptsdirect.net |
Other providers in Painesville, OH
- Bileci LLC
- Paul Anders Bjorn
- Daniel James Blair
- Jodi M Blankenship
- Daniel Paul Blore
- Baylee Bond
- Marie Borovic
- Megan Bosland
- Rob Bottiggi
- Antoinette Bower
All providers in Painesville, OH · Otolaryngology Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.