Bollin, Kenneth W

Bollin, Kenneth W is an individual health care provider with primary practice located at 24911 Little Mack Ave , Saint Clair Shores MI 48080-3200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bollin, Kenneth W can be contacted via phone (586) 777-2050.

Contact Information

Primary practice address
24911 Little Mack Ave Saint Clair Shores MI 48080-3200
Phone: (586) 777-2050
Fax: (586) 777-2189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301041272 Michigan

Profile Details

NPI number 1144212788
LBN Legal business name Bollin, Kenneth W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Feb 18th, 2014 - about 10 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 1144212788 NPPES
Michigan MEDICAID 2607916

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