Provider Demographics
NPI:1811583131
Name:DOLAN, STEVEN (MB BCH BAO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:DOLAN
Suffix:
Gender:M
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 IVELEY ROAD
Mailing Address - Street 2:CLAPHAM
Mailing Address - City:LONDON
Mailing Address - State:UK - UNITED KINGDOM
Mailing Address - Zip Code:SW40EW
Mailing Address - Country:GB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6106
Practice Address - Country:US
Practice Address - Phone:857-282-4347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program