Individual
MICHAEL R BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
503 S STATE ST, CLARKS SUMMIT, PA 18411-1557
(570) 587-5186
(570) 586-7973
Mailing address
2661 RIVA RD STE 1030, ANNAPOLIS, MD 21401-7131
(667) 354-5528
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000077
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001699824
—
PA
01
—
180033988
RAILROAD MEDICARE
—
01
—
49959
GEISINGER HEALTH PLAN
—
01
—
506554
AETNA
—
01
—
806719
FIRST PRIORITY HEALTH
—
01
—
BO975359
HIGH MARK BLUE SHIELD
—
Enumeration date
08/13/2006
Last updated
03/21/2026
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