MEDICARE: ROBERT DRAKE BOLEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	38040	SC
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1568751717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT DRAKE BOLEN M.D.

Provider Business Mailing Address
First Line	:	96 JONATHAN LUCAS ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8900
Country	:	US
Telephone Number	:	843-792-3220
Fax Number	:

Provider Business Practice Location Address
First Line	:	MEDICAL UNIVERSITY OF SOUTH CAROLINA
Second Line	:	96 JONATHAN LUCAS STREET, CSB 301
City	:	CHARLESTON
State	:	SC
Zip	:	29425-6160
Country	:	US
Telephone Number	:	843-792-3221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2011
Last Update Date	:	09/10/2015

Similar Medicare Providers

1891503249 — SHANA YALA WABIBI PA-C
Practice Location Address:

151A RUTLEDGE AVE
CHARLESTON, SC
29425-8903

Practice Phone: 704-807-2601
Practice Fax:

1871086926 — DR. LUKE RICHARD CYPHER MD, PHD
Practice Location Address:

169 ASHLEY AVE RM 202
CHARLESTON, SC
29425-8905

Practice Phone: 842-792-2575
Practice Fax:

1972221190 — KATHRYN SARAH SZCZECHOWSKI DNP, RN, AGACNP-BC
Practice Location Address:

171 ASHLEY AVE
CHARLESTON, SC
29425-6712

Practice Phone: 843-792-1414
Practice Fax:

1023527504 — ROSAURA ORENGO-AGUAYO PHD
Practice Location Address:

67 PRESIDENT ST # 863
CHARLESTON, SC
29425-5712

Practice Phone: 843-792-2947
Practice Fax:

1801752696 — ERICA LORRAINE TOLLERSON
Practice Location Address:

25 COURTENAY DR
CHARLESTON, SC
29425-8911

Practice Phone: 843-792-2900
Practice Fax:

1659237394 — JONATHAN FEAGIN
Practice Location Address:

268 CALHOUN ST
CHARLESTON, SC
29425-8906

Practice Phone: 843-792-5252
Practice Fax:

Directions to “ ROBERT DRAKE BOLEN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.