RICHARD GERALD BOLANOS JR. (NPI# 1225358369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225358369 |
| Entity Type | Individual |
| Full Name | RICHARD GERALD BOLANOS JR. |
| Other Name | RICARDO G BOLANOS |
| Credential | M.D. |
| Practice Address |
4352 Manchester Ave Saint Louis MO 63110-2138 |
| Practice Telephone | 3145315444 |
| Practice Fax Number | 3145310063 |
| Mailing Telephone | 3145315444 |
| Mailing Fax Number | 3145310063 |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2014-07-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 2010020453 | MO | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
4352 MANCHESTER AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-2138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245214394 | Harry Richard Scharf | Dentist | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2005-12-02 |
| 1881291847 | Chelsea Marie Pierce | Nurse Practitioner | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2020-10-02 |
| 1376058586 | Jordanna Riebel | Psychologist | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2017-12-11 |
| 1184143596 | Vicki Swyers | Social Worker | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2017-09-18 |
| 1407384902 | Alexia Marie Munter | Nurse Practitioner | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2017-05-27 |
| 1770961492 | Bobbi Omori Lakin | Family Medicine | 4352 Manchester Ave, Saint Louis, MO 63110 | 2015-05-14 |
| 1760772966 | Kenneth Edmond Hemba | Family Medicine | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2011-04-10 |
| 1053617407 | Coleen R. Jones | Nurse Practitioner | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2011-02-02 |
| 1588891576 | Treena Sturgeon | Internal Medicine | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2009-06-17 |
| 1881850576 | Kathryn A Simon | Dentist | 4352 Manchester Ave, Saint Louis, MO 63110-2138 | 2008-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568984367 | Gsh Lab LLC | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 1017b, Saint Louis, MO 63141-8264 | 2017-07-13 |
| 1851825715 | Sydni Fazenbaker Crowell | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2009b, Saint Louis, MO 63141 | 2017-04-18 |
| 1962865170 | Zachary Keller | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 499a, Saint Louis, MO 63141-8260 | 2016-04-04 |
| 1174985154 | Leah Hong | Obstetrics & Gynecology | 6420 Clayton Rd Ste 2800, Saint Louis, MO 63117-1811 | 2016-03-28 |
| 1972997088 | Jennifer E Powel | Obstetrics & Gynecology | 6420 Clayton Rd Ste 230-a, Saint Louis, MO 63117-1811 | 2015-03-26 |
| 1386068864 | Wcc 2, LLC | Obstetrics & Gynecology | 3023 N Ballas Rd Bldg D, Suite 120d, Saint Louis, MO 63131-2330 | 2014-02-05 |
| 1881987410 | Herman Taute | Obstetrics & Gynecology | 12040 Heatherdane Dr, Saint Louis, MO 63131-3119 | 2011-05-16 |
| 1174828198 | Frank Eugene Hunleth | Obstetrics & Gynecology | 5331 Donovan Ave, Saint Louis, MO 63109-2635 | 2011-01-22 |
| 1972804631 | Anastasios K Dagartzikas | Obstetrics & Gynecology | 12902 Tundra Ct, Saint Louis, MO 63131-1319 | 2010-11-11 |
| 1811227390 | Laurel D Fendrich | Obstetrics & Gynecology | 10010 Kennerly Rd Fl 4, Saint Louis, MO 63128 | 2010-01-06 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.