# MR. TIMOTHY A BOLYARD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891769063
- **Gender:** Man
- **Credential:** PA C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 284 | WV | Yes |

## Other

- **Enumeration date:** 02/15/2006
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1804868000 | — | WV |