Randall J. Bolar in Detroit Lakes - Surgery
Randall J. Bolar - NPI 1558323246
Randall J. Bolar is a Surgery in Detroit Lakes, Minnesota. Randall J. Bolar practices all healthcare services and medical treatments related to Surgery. The NPI Number for Randall J. Bolar is 1558323246. The last update date is 2015-12-23.
Randall J. Bolar's current location address is 1027 Washington Ave, Detroit Lakes, Minnesota. You can contact this provider via phone number 2188475611 and fax number 2188470881. The mailing address for Randall J. Bolar is 1027 Washington Ave, Detroit Lakes, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randall J. Bolar |
|---|---|
| Address | 1027 Washington Ave, Detroit Lakes, Minnesota |
| Phone Number | 2188475611 |
| Fax Number | 2188470881 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1558323246 |
|---|---|
| Provider Enumeration Date | 2006-04-06 |
| Last Updated Date | 2015-12-23 |
Provider Mailing Address Detail
| Address | 1027 Washington Ave |
|---|---|
| City | Detroit Lakes |
| State | Minnesota (MN) |
| Post Code | 565013409 |
| Phone Number | 2188475611 |
| Fax Number | 2188470881 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 34949 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1515147 | TN | -- | |
| TN0125 | TN | AMERICHOICE | |
| 203500913011 | TN | TRICARE | |
| 69481 | KY | ANTHEM BC | |
| 10802394 | CAQH | ||
| 1558323246 | MN | -- | |
| 1281517 | TN | AMERIGROUP | |
| 4221186 | TN | BCBS | |
| 64357130 | KY | -- | |
| 7774037 | KY | AETNA |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Randall J. Bolar by the Centers for Medicare & Medicaid Services?
The Randall J. Bolar has been issued the NPI (National Provider Identifier) 1558323246, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Randall J. Bolar is physically located?
The Randall J. Bolar is physically situated at the following address: 1027 Washington Ave, Detroit Lakes, MN, 565013409.
What is the area of specialization for Randall J. Bolar, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Randall J. Bolar is Surgery, and the corresponding taxonomy code that categorizes this area of expertise is 208600000X.
On what date did the Randall J. Bolar receive its 1558323246 assignment from the Centers for Medicare & Medicaid Services?
The Randall J. Bolar was assigned its 1558323246 by the Centers for Medicare & Medicaid Services on 2006-04-06.
When was the information related to Randall J. Bolar most recently updated or refreshed?
The details pertaining to the Randall J. Bolar, including its address, specialty, and other relevant information, were last updated or refreshed on 2015-12-23.