Basic Information
| Provider Information | |||||||||
| NPI: | 1013908219 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOLAND | ||||||||
| FirstName: | ARTHUR | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 CAMBRIDGE ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021142797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176432259 | ||||||||
| FaxNumber: | 6177263438 | ||||||||
| Practice Location | |||||||||
| Address1: | 175 CAMBRIDGE ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021142797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176432259 | ||||||||
| FaxNumber: | 6177263438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2005 | ||||||||
| LastUpdateDate: | 01/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 31055 | MA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | M07379 | 01 | MA | BCBS MA | OTHER | 2026864 | 05 | MA | MEDICAID | 701139 | 01 | MA | TUFTS HEALTH PLAN | OTHER |