Organization
BRUCE R BOLLING & GWENDOLYN W BOLLING PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE BOLLING MD (OWNER)
(336) 659-9440
Entity
Organization
Contact information
Practice address
3001 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4020
(336) 659-9440
(336) 659-9845
Mailing address
3001 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4020
(336) 659-9440
(336) 659-9845
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
592
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48204
BCBS NC
NC
05
—
8948204
—
NC
Enumeration date
03/11/2008
Last updated
02/03/2011
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