Individual
MR. BRUCE RICHARD BOLLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
174400000X
Specialist
Primary
592
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127RY
BCBS
NC
05
—
89127RY
—
NC
Enumeration date
08/25/2006
Last updated
07/09/2007
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