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1922070762
MARK D BOLDT
SAINT PAUL, MN
NPI
1922070762
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: MN R0901701)
Enumeration Date
2006-02-06
Last Update Date
2007-10-29
Business Address
-- MARK D BOLDT NP
2550 UNIVERSITY AVE W SUITE 423 SOUTH
SAINT PAUL, MN 55114-1052
Phone number: 612-870-5557
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Mailing Address
-- MARK D BOLDT NP
PO BOX 14909
MINNEAPOLIS, MN 55414-0909
Phone number: 612-870-5557
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