Individual
BRUCE BOLASNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
103 WOLF CREEK BLVD, SUITE 1, DOVER, DE 19901-4915
(302) 674-2420
(302) 674-4473
Mailing address
103 WOLF CREEK BLVD, SUITE 1, DOVER, DE 19901-4915
(302) 674-2420
(302) 674-4473
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C1-0000582
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001156101
—
DE
Enumeration date
07/01/2005
Last updated
07/08/2007
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