Provider Demographics
NPI:1508254269
Name:BOLSTER, FERDIA (MD, MB BCH BAO)
Entity Type:Individual
Prefix:
First Name:FERDIA
Middle Name:
Last Name:BOLSTER
Suffix:
Gender:M
Credentials:MD, MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE
Mailing Address - Street 2:HARBOURVIEW MEDICAL CENTER, UNIVERSITY OF WASHINGTON
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2420
Mailing Address - Country:US
Mailing Address - Phone:206-744-3561
Mailing Address - Fax:206-744-8560
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:HARBOURVIEW MEDICAL CENTER, UNIVERSITY OF WASHINGTON
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-3561
Practice Address - Fax:206-744-8560
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAML 605227862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology