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Contact Information

KEITH C BOLDON, MD
435 LEWIS AVE
MERIDEN, CT06451-2101
 Phone: 203-694-8200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for KEITH C BOLDON · (Male)

NPI Number 1316126444
Status Active
Credentials MD
Entity Individual
Enumeration date 10/25/2007
Last updated 06/23/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 043896
  • CT Medicaid 1316126444
Hospital affiliation(s)
  • MIDSTATE MEDICAL CENTER - (Acute Care)
    435 LEWIS AVE
    MERIDEN, CT 06450
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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