DR. KELLY MICHELLE BOLDEN (NPI# 1265616007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265616007 |
| Entity Type | Individual |
| Full Name | DR. KELLY MICHELLE BOLDEN |
| Credential | MD |
| Practice Address |
5301 Wisconsin Ave Nw Ste 100 Washington DC 20015-2070 |
| Mailing Address |
4834 Blagden Ave Nw Washington DC 20011-3716 |
| Practice Telephone | 2022379292 |
| Mailing Telephone | 2022300364 |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2020-05-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | MD040080 | DC | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | D0071243 | MD | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2041 Georgia Ave Nw Tower 4000, Washington, DC 200603076 | 2028653785 | 2028653131 |
| Street Address |
5301 WISCONSIN AVE NW STE 100 |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20015-2070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598265944 | Family Orthodontics of Dc Pllc | Dentist | 5301 Wisconsin Ave Nw Ste 200, Washington, DC 20015 | 2018-02-12 |
| 1417351578 | Kelly Barnes | Registered Nurse | 3608 Rittenhouse St Nw, Washington, DC 20015 | 2014-10-20 |
| 1093143729 | Diana Kwan | Pharmacist | 5335 Wisconsin Ave, Washington, DC 20015 | 2013-10-15 |
| 1265867790 | Kimberly Roberts Perks | Occupational Therapist | 3200 Military Rd Nw, Washington, DC 20015 | 2013-09-03 |
| 1013356708 | Jason Douglas Wemmers | Psychologist | 5225 Wisconsin Ave, Nw, Suite 400, Washington, DC 20015 | 2013-06-17 |
| 1427364256 | Saralyn Mark | Internal Medicine | 4208 Ingomar St, Nw, Washington, DC 20015 | 2010-08-31 |
| 1205061108 | Stanley Isaac Rapoport | General Practice | 3050 Military Road Nw, Apt. 935, Washington, DC 20015 | 2009-05-20 |
| 1447410113 | Bonnie Cho | Dentist | 5212 Connecticut Ave Nw, Washington, DC 20015 | 2008-06-16 |
| 1184804015 | Daniel Samuel Pine | Psychiatry & Neurology | 5225 Wisconsin Avenue Nw, Suite 400 The Ross Center, Washington, DC 20015 | 2007-11-08 |
| 1821291659 | John M Dluhy Jr. | Psychiatry & Neurology | 3709 Ingomar St Nw, Washington, DC 20015 | 2007-06-08 |
| Find all providers in zip 20015 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023672987 | Pearl Ann Theresa Brown | Plastic Surgery | 21 7th St Se, Washington, DC 20003-1221 | 2019-04-26 |
| 1053610832 | Laura Kate Tom | Plastic Surgery | 106 Irving St Nw Ste 3400, Washington, DC 20010 | 2011-03-20 |
| 1760705594 | Craig Davis | Plastic Surgery | 3163 N Grasslands Pkwy, Washington, UT 84780-2097 | 2010-03-08 |
| 1487801627 | Grant Michael Kleiber | Plastic Surgery | 3800 Reservoir Rd Nw # Phc1, Washington, DC 20007-2113 | 2008-08-19 |
| 1609908334 | Anita R Kulkarni | Plastic Surgery | 2440 M St Nw Ste 318, Washington, DC 20037 | 2007-03-09 |
| 1194750224 | Mary Ella M Carter | Plastic Surgery | Veterans Affairs Hospital 50 Irving Street, Plastic Surgery, Washington, DC 20422-0001 | 2006-07-11 |
| 1386640118 | Henry Paul Jr. | Plastic Surgery | 2041 Georgia Avenue Nw Dept of Surgery, Washington, DC 20060-3322 | 2005-06-27 |
| 1265435804 | Teresa Marie Buescher | Plastic Surgery | 2300 M St Nw, 6th Floor, Washington, DC 20037-1434 | 2005-05-27 |
| 1265082564 | Catherine M Hannan, Md, Pllc | Plastic Surgery | 2440 M St Nw Ste 200, Washington, DC 20037-1449 | 2019-09-18 |
| 1013490267 | Dc Plastic Surgery Boutique LLC | Plastic Surgery | 2440 M St Nw Ste 318, Washington, DC 20037-1472 | 2018-09-13 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20015 |
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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.