Provider Demographics
NPI:1134508914
Name:BOLZ, EVERETT ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:ARTHUR
Last Name:BOLZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5318 SANDTRAP LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-7978
Mailing Address - Country:US
Mailing Address - Phone:704-544-2244
Mailing Address - Fax:
Practice Address - Street 1:5710 W. HAUSMAN RD. SUITE 105
Practice Address - Street 2:GTW CONSULTANTS & ASSOCIATES
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1646
Practice Address - Country:US
Practice Address - Phone:210-424-2094
Practice Address - Fax:484-489-2816
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC171412083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine