Individual
ALEXANDER M BOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5551 WINGHAVEN BLVD, SUITE 132, O FALLON, MO 63368-3617
(636) 695-2514
(636) 695-2526
Mailing address
PO BOX 957415, SAINT LOUIS, MO 63195-0001
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
36068
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201784709
—
MO
01
—
990009648
RAILROAD MEDICARE
MO
Enumeration date
06/02/2006
Last updated
10/09/2008
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