Individual
DR. NICHOLAS R. BOLLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3 MALPHRUS RD STE 101, BLUFFTON, SC 29910-6635
(843) 837-9222
(843) 837-4474
Mailing address
3 MALPHRUS RD STE 101, BLUFFTON, SC 29910-6635
(843) 837-9222
(843) 837-4474
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1463
SC
152W00000X
Optometrist
OPT002419
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511G701032
MEDICARE GROUP
GA
01
—
511I410154
MEDICARE PTAN
GA
01
—
6830
MEDICARE GROUP NUMBER
SC
05
—
895091476D
—
GA
05
—
895091476F
—
GA
01
—
AA62946830
MEDICARE PTAN
SC
05
—
D14633
—
SC
01
—
DA9680
MEDICAID GROUP NUMBER
SC
01
—
P00684230
RAILROAD MEDICARE PTAN
GA
Enumeration date
07/13/2006
Last updated
02/20/2025
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