Individual
ALAN RANDAL BOLLINGER
Active
Individual
ALAN RANDAL BOLLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
DO-02348
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0421628
—
IA
01
—
1295830115
MEDICARE PTAN IB3072001
IA
Enumeration date
09/14/2006
Last updated
05/31/2018
Update your record
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