Provider Demographics
NPI:1801811906
Name:BOLAND, RACHAEL E (MD)
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:E
Last Name:BOLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5885 HARRISON AVE
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-1691
Mailing Address - Country:US
Mailing Address - Phone:513-922-9660
Mailing Address - Fax:513-347-2347
Practice Address - Street 1:151 W GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45216-1015
Practice Address - Country:US
Practice Address - Phone:513-418-2639
Practice Address - Fax:513-418-2516
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-088009207R00000X
OH35.088009208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2698602Medicaid
KY7100108860Medicaid
KY7100108860Medicaid
OH4189761Medicare PIN
OHP00411130OtherRR MEDICARE
OH2698602Medicaid