Individual
DR. LISA M BOLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6490 EXCELSIOR BLVD, STE W300, ST LOUIS PARK, MN 55426-4705
(952) 993-3242
Mailing address
6465 WAYZATA BLVD, STE 315, ST LOUIS PARK, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
44513
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082087300
—
MN
Enumeration date
12/29/2005
Last updated
07/05/2012
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