Provider Demographics
NPI:1821128828
Name:BOLTON, VINCENT E (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:E
Last Name:BOLTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04046-6112
Mailing Address - Country:US
Mailing Address - Phone:207-468-2757
Mailing Address - Fax:
Practice Address - Street 1:6 WASHINGTON CT
Practice Address - Street 2:
Practice Address - City:KENNEBUNKPORT
Practice Address - State:ME
Practice Address - Zip Code:04046-6112
Practice Address - Country:US
Practice Address - Phone:207-468-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME12952207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology