Individual
MRS. MEGAN S BOLTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1223 S LAKE DR STE G, LEXINGTON, SC 29073-6889
(803) 520-9370
(803) 520-9371
Mailing address
2214 OLD CHEROKEE RD, LEXINGTON, SC 29072-9725
(803) 520-9380
(803) 520-5972
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
LL 29052
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3549
—
SC
05
—
400685
—
SC
Enumeration date
03/20/2007
Last updated
07/21/2022
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