Provider Demographics
NPI:1558407965
Name:GARY E. BOLLIN, M.D., LLC
Entity Type:Organization
Organization Name:GARY E. BOLLIN, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOLLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-344-6643
Mailing Address - Street 1:224 W EXCHANGE ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1704
Mailing Address - Country:US
Mailing Address - Phone:330-344-6643
Mailing Address - Fax:330-762-7196
Practice Address - Street 1:224 W EXCHANGE ST
Practice Address - Street 2:SUITE 290
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1704
Practice Address - Country:US
Practice Address - Phone:330-344-6643
Practice Address - Fax:330-762-7196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty