Individual
DAVID ERIC BOLSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1516 OLD TROLLEY RD # 101, SUMMERVILLE, SC 29485-8209
(843) 203-9393
(843) 492-4673
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16913
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169132
—
SC
01
—
P00721734
RR MEDICARE
SC
Enumeration date
12/14/2005
Last updated
07/06/2021
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