Individual
COREY SCOFIELD BOLAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 ERWIN RD, T, DURHAM, NC 27705-3941
(919) 684-8111
Mailing address
PO BOX 63362, CHARLOTTE, NC 28263-3362
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2013-00809
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2009
Last updated
07/31/2013
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