Lookup NPI Numbers from the NPI Registry
NPI Profile for DARAYU C BOLTAEVA in MARSHFIELD, WI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant | |
Physician Assistant |
363A00000X | 97 | Physician Assistant |
| NPI # | 1912714692 |
|
| Status | Active | |
| Credentials | DMS, PA-C | |
| Entity | Individual | |
| Enumeration date | 12/16/2024 | |
| Last updated | 04/01/2025 - More than a year ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DARAYU C BOLTAEVA
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DARAYU C BOLTAEVA, DMS, PA-C