Provider Demographics
NPI:1538160551
Name:BOLCER, SARAH HINTZ (DPM)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:HINTZ
Last Name:BOLCER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19230 EVANS ST NW
Mailing Address - Street 2:STE 109
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-1079
Mailing Address - Country:US
Mailing Address - Phone:763-441-6220
Mailing Address - Fax:763-441-2207
Practice Address - Street 1:19230 EVANS ST NW
Practice Address - Street 2:STE 109
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-1079
Practice Address - Country:US
Practice Address - Phone:763-441-6220
Practice Address - Fax:763-441-2207
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN614213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN737612000Medicaid
MNU74382Medicare UPIN