Healthcare Provider Details

I. General information

NPI: 1518372655
Provider Name (Legal Business Name): CRAIG ALLEN BOLLIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 09/01/2022
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DRIVE, MC H091
HERSHEY PA
17033-0853
US

IV. Provider business mailing address

10 PLUM ST FL 5
NEW BRUNSWICK NJ
08901-2066
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-8945
  • Fax: 717-531-6160
Mailing address:
  • Phone: 732-235-5530
  • Fax: 732-235-7220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD478740
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: