Individual
DR. ALAN M BOLASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
659 HOSPITAL RD, 101, TAPPAHANNOCK, VA 22560
(804) 433-6020
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2921
(703) 766-9737
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101035140
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00570516-9
—
VA
01
—
050001075
MEDICARE
VA
Enumeration date
06/01/2005
Last updated
05/07/2015
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