Individual
KIMBERLY WILLIAMS BOLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4924 CAMPBELL BLVD, NOTTINGHAM, MD 21236-5908
(443) 442-2200
Mailing address
PO BOX 64481, BALTIMORE, MD 21264-4481
(410) 955-5080
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1486
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151600100
—
MD
Enumeration date
06/27/2006
Last updated
02/21/2013
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