Individual
RONI J. BOLLAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-0746
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-8401
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
000963
GA
Other
Enumeration date
04/04/2007
Last updated
10/25/2012
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