Provider Demographics
NPI:1275787202
Name:BOLEY, SHEREE (RN,CDE)
Entity Type:Individual
Prefix:MRS
First Name:SHEREE
Middle Name:
Last Name:BOLEY
Suffix:
Gender:F
Credentials:RN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 CAMERON VALLEY PKWY
Mailing Address - Street 2:SUITE 4100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3546
Mailing Address - Country:US
Mailing Address - Phone:704-302-8310
Mailing Address - Fax:704-302-8311
Practice Address - Street 1:4525 CAMERON VALLEY PKWY
Practice Address - Street 2:SUITE 4100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3546
Practice Address - Country:US
Practice Address - Phone:704-302-8310
Practice Address - Fax:704-302-8311
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207259207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism