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General NPI Number Information
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NPI Number | 1003831371
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Entity Type | Individual
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Provider Name | NICHOLAS R. BOLLIN OD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 3 MALPHRUS RD STE 101
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City | BLUFFTON
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State | SC
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Zip | 29910-6635
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Country | US
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Telephone | 843-837-9222
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Fax | 843-837-4474
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Provider Business Mailing Address
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Address Line | 3 MALPHRUS RD STE 101
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City | BLUFFTON
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State | SC
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Zip | 29910-6635
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Country | US
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Telephone | 843-837-9222
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Fax | 843-837-4474
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT002419
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1463
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License Number State | SC
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