Provider Demographics
NPI:1093128902
Name:BOLEN, KIMBERLY CURRY (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CURRY
Last Name:BOLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:AMANDA
Other - Last Name:CURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1801 SUNSET DR
Mailing Address - Street 2:CHILDREN'S HOSPITAL OUTPATIENT CENTER
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-6155
Mailing Address - Fax:803-434-6979
Practice Address - Street 1:1801 SUNSET DR
Practice Address - Street 2:CHILDREN'S HOSPITAL OUTPATIENT CENTER
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-6155
Practice Address - Fax:803-434-6979
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL36981208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics