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Willie Mary Bolden
NPI 1518428283 · on the registry since 2019
Practice
- Address
- 112 W Peeler Ave
Shaw, MS 38773 - Phone
- (662) 745-6638
- Organisation at this address
- Shaw Family Medical, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-03-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi