| Doctor Name: | DR. DELANO W. BOLTER |
| NPI Number: | 1972522431 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 0101017584 |
| Business Practice Address: | 434 Mitchell Valley Dr Marion, VA - 243546338 |
| Business Phone Number: | 2767837600 |
| Business Fax Number: | 2767831802 |
| Mailing Address: | 748 Sherwood Dr, P.o. Box 1007 MARION |
| State: | VA |
| Postal Code: | 243544621 |
| Phone Number: | 2767834076 |
| Fax Number: | |
| NPI Enumeration Date: | 07/18/2006 |
| NPI Last Update Date: | 07/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261Q00000X |
| License Number: | 0101017584 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |