Bruce R Bolling & Gwendolyn W Bolling PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

592 Issued in NC

Legal business name

BRUCE R BOLLING & GWENDOLYN W BOLLING PA

Practice address

3001 Maplewood Ave
Winston Salem, NC 27103-4020

Phone

(336) 659-9440

Fax

(336) 659-9845

NPI assigned

Mar 11, 2008

Organization subpart

No

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

Authorized official

Name

Bruce Bolling, MD

Title

Owner

Phone

(336) 659-9440

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1568632008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034020",
            "telephone_number": "336-659-9440",
            "fax_number": "336-659-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034020",
            "telephone_number": "336-659-9440",
            "fax_number": "336-659-9845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE R BOLLING & GWENDOLYN W BOLLING PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "BOLLING",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-659-9440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": "592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "48204",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8948204",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Burley Browning, ATC
• Darlene Brownlee, CRNP
• Kelly Ann Brozzetti-Cronin, M.D.
• Douglas Brtalik, D.O.
• Bruce M. Wheeler, DMD, PA
• David Robert Bruce, LCSW, MSW
• Karen Elizabeth Bruestle-Wallace, PHARMD
• Joel Thomas Bruggen, MD
• Candace Leigh Brumley, OT STUDENT
• Nicole Marie Brunner, CNM

• Surgery Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.