DANIEL A BOLL MD NPI 1487648184

NPI Information

  • NPI: 1487648184
  • Provider Name: DANIEL A BOLL, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • Address: 620 W EDISON RD
    SUITE 110
    MISHAWAKA, IN
    ZIP 46545
  • Phone: (574) 258-1100

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NPI Details

Daniel A Boll, MD is a diagnostic radiology radiology in Mishawaka, IN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Daniel A Boll, MD NPI is 1487648184. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

620 W EDISON RD
SUITE 110
MISHAWAKA, IN
ZIP 46545-784
Phone: (574) 258-1100
Fax: (574) 258-1101

The enumeration date for this NPI number is 9/8/2005 and was last updated on 5/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085N0904XRadiologyNuclear Radiology01035496INDIANANo
22085B0100XRadiologyBody Imaging01035496INDIANANo
32085N0700XRadiologyNeuroradiology01035496INDIANANo
42085P0229XRadiologyPediatric Radiology01035496INDIANANo
52085R0203XRadiologyTherapeutic Radiology01035496INDIANANo
62085R0204XRadiologyVascular & Interventional Radiology01035496INDIANANo
72085U0001XRadiologyDiagnostic Ultrasound01035496INDIANANo
82085R0202XRadiologyDiagnostic Radiology01035496INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1728230TMEDICARE PININDIANA
2200001800MEDICAIDINDIANA
3E47568MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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