Individual
STANLEY W BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
503 S STATE ST, CLARKS SUMMIT, PA 18411
(570) 587-5186
(570) 586-7973
Mailing address
200 MIFFLIN AVE, SCRANTON, PA 18503
(570) 342-3145
(570) 344-1309
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD028117L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072551
FIRST PRIORTIY HEALTH
—
01
—
16915
GEISINGER HEALTH PLAN
—
01
—
506554
AETNA
—
01
—
BO019514
HIGH MARK BLUE SHIELD
—
Enumeration date
08/31/2006
Last updated
07/08/2007
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