Individual
SHAWN A BOLLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
225 E WOOD ST, SPARTANBURG, SC 29303-3050
(864) 560-4420
(864) 560-5296
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2363
SC
363AS0400X
Surgical Physician Assistant
10000462A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000375781
BCBS PIN
—
05
—
2241PA
—
SC
01
—
970018928
RAILROAD MEDICARE PIN
—
Enumeration date
07/14/2006
Last updated
01/12/2021
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