Individual provider · Type 1 NPI
Darayu C. Boltaeva, DMS, PA-C
Surgical Physician Assistant · Marshfield, WI
NPI number
1912714692
Active
Practice location
1000 N Oak Ave
Marshfield, WI 54449-5703
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | None listed |
| Surgical Physician Assistant Primary | 363AS0400X | 8239 (WI) |
Surgical Physician Assistant: Definition to come...
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About NPI 1912714692
Darayu C. Boltaeva, DMS, PA-C's National Provider Identifier is 1912714692, issued on Dec 16, 2024. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Marshfield, WI. The record was last updated on Apr 1, 2025.