Provider Demographics
NPI:1225029374
Name:BOLLINGER, STEVEN H (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:H
Last Name:BOLLINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1900 CENTRACARE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-240-2205
Mailing Address - Fax:320-229-5174
Practice Address - Street 1:1900 CENTRACARE CIR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-240-2205
Practice Address - Fax:320-229-5174
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN36474207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
100000454OtherMEDICARE
123622OtherU CARE
2129271OtherFIRST HEALTH PLAN
CQ2388OtherRR MEDICARE
502R1BOOtherBLUE CROSS BLUE SHIELD
806765100OtherMEDICAL ASSISTANCE
1020103OtherPREFERRED ONE
68D58BOOtherBLUE CROSS BLUE SHIELD
795453OtherARAZ GROUP AMERICAS PPO
100012940OtherRR MEDICARE
2900212OtherMEDICA HEALTH PLANS
HP23378OtherHEALTH PARTNERS
2900212OtherMEDICA HEALTH PLANS