KENNETH W BOLLIN MD NPI 1144212788

NPI Information

NPI: 1144212788
Provider Name: KENNETH W BOLLIN, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI
ZIP 48080
Phone: (586) 777-2050
Get Directions

Kenneth W Bollin, MD is a family medicine in Saint Clair Shores, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Kenneth W Bollin, MD NPI is 1144212788. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI
ZIP 48080-200
Phone: (586) 777-2050
Fax: (586) 777-2189

The enumeration date for this NPI number is 8/19/2005 and was last updated on 2/18/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		4301041272	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	A74264	MEDICARE UPIN
2	M71670079	MEDICARE ID-TYPE UNSPECIFIED
3	2607916	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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