Individual
MR. TIMOTHY A BOLYARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
411 MORGANTOWN ST, KINGWOOD, WV 26537
(304) 329-0555
(304) 329-0556
Mailing address
411 MORGANTOWN ST, KINGWOOD, WV 26537
(304) 329-0555
(304) 329-0556
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
284
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1804868000
—
WV
Enumeration date
02/15/2006
Last updated
07/08/2007
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