Bolar, Randall J.

Bolar, Randall J. is an individual health care provider with primary practice located at 1027 Washington Ave , Detroit Lakes MN 56501-3409. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bolar, Randall J. can be contacted via phone (218) 847-5611.

Contact Information

Primary practice address
1027 Washington Ave Detroit Lakes MN 56501-3409
Phone: (218) 847-5611
Fax: (218) 847-0881
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 34949 Tennessee
Allopathic & Osteopathic Physicians / Surgery 208600000X 36945 Minnesota

Profile Details

NPI number 1558323246
LBN Legal business name Bolar, Randall J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Dec 23rd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558323246 NPPES
Tennessee MEDICAID 1515147
Tennessee Other TN0125
Tennessee Other 203500913011
Tennessee Other 000000069481
Tennessee Other 10802394
Tennessee MEDICAID 1558323246
Tennessee Other 01281517
Tennessee Other 4221186
Tennessee MEDICAID 64357130
Tennessee Other 7774037
Tennessee MEDICAID 3338849

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