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Individual

BEVIN LASHLEY DOLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
100 E LANCASTER AVE, MOB EAST 556, WYNNEWOOD, PA 19096-3450
(610) 896-0210
(610) 896-5101
Mailing address
100 E LANCASTER AVE, MOB EAST 556, WYNNEWOOD, PA 19096-3450
(610) 896-0210
(610) 896-5101

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MT182645
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002024432
HIGHMARK BLUE SHIELD
05
1021146200001
PA
01
3502778000
INDEPENDENCE BLUE CROSS
Enumeration date
10/29/2007
Last updated
01/22/2020
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