Provider Demographics
NPI:1386756799
Name:BOHLMAN, MICHAEL SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:BOHLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E ALMOND AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5692
Mailing Address - Country:US
Mailing Address - Phone:559-675-1231
Mailing Address - Fax:
Practice Address - Street 1:1100 E ALMOND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5692
Practice Address - Country:US
Practice Address - Phone:559-675-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94482207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine