Steven James Bollom, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

31273 Issued in WI

Practice address

2793 Lineville Rd
Green Bay, WI 54313-7152

Phone

(920) 496-4700

Fax

(920) 496-4704

NPI assigned

Jul 13, 2006

Last updated

Jul 16, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1467477786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "address_2": "PREVEA HEALTH",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700",
            "fax_number": "920-496-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2793 LINEVILLE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137152",
            "telephone_number": "920-496-4700",
            "fax_number": "920-496-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLOM",
        "first_name": "STEVEN",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "31273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31819400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee L Bohnart, NP
• Elizabeth Bohrer, PAC
• Melissa Lynn Boldt, FNP-C
• Trisha M Boldt, D-PT
• Kayla M Bollech, RN
• Amie Rose Bomber
• Steven A Bomkamp, APNP
• Antonino Bommarito, PA-C
• Lynn Marie Bond, PHARMACIST
• Katherine Ann Bongel, LPN

• Internal Medicine Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.