Provider Demographics
NPI:1689682965
Name:BOLINGER, CHERYL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:BOLINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 NEW CASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5821
Mailing Address - Country:US
Mailing Address - Phone:302-655-6187
Mailing Address - Fax:302-655-6606
Practice Address - Street 1:601 NEW CASTLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5821
Practice Address - Country:US
Practice Address - Phone:302-655-6187
Practice Address - Fax:302-655-6606
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMD1775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000089601Medicaid
821833Medicare UPIN
DE000089601Medicaid
DEP00631316Medicare PIN