Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NI0013X | Independent Medical Examiner | 3740-012 | WI |
Y | 111NI0013X | Independent Medical Examiner | CHIR005293 | GA |
NPI | 1740368182 |
---|---|
Provider Name | Dr. Valerie Joy Bohland |
First Address | Mcdonough, GA 30253-5477 |
Second Address | Mcdonough, GA 30253-5477 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 13/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U55500 | (02) | GA |