MEDICARE: MRS. GWENDOLYN MARY WIGAND BOLLING MD

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	207Q00000X	Family Medicine Physician	2000001333	NC
2	207R00000X	Internal Medicine Physician	2000001333	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902892086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GWENDOLYN MARY WIGAND BOLLING MD

Provider Business Mailing Address
First Line	:	PO BOX 751803
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1803
Country	:	US
Telephone Number	:	336-718-0100
Fax Number	:	336-718-0120

Provider Business Practice Location Address
First Line	:	1381 WESTGATE CENTER DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2934
Country	:	US
Telephone Number	:	336-718-0100
Fax Number	:	336-718-0120

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	04/26/2023

Similar Medicare Providers

1679351126 — ROWAN HALL KNIGHT CPP, PHARM D
Practice Location Address:

1381 WESTGATE CENTER DR
WINSTON SALEM, NC
27103-2934

Practice Phone: 336-718-0100
Practice Fax: 336-718-0120

1063415362 — SCOTT L TUCKER MD
Practice Location Address:

1345A WESTGATE CENTER DR
WINSTON-SALEM, NC
27103-2934

Practice Phone: 336-768-8483
Practice Fax: 336-768-1195

1891799433 — JOHN WALLACE GALBREATH MD
Practice Location Address:

1381 WESTGATE CENTER DR
WINSTON SALEM, NC
27103-2934

Practice Phone: 336-718-0100
Practice Fax: 336-718-0120

1730180928 — MRS. SHARYN N CONRAD DNP, FNP-BC
Practice Location Address:

1381 WESTGATE CENTER DR
WINSTON SALEM, NC
27103-2934

Practice Phone: 336-718-0100
Practice Fax: 336-718-0120

1912909748 — CHARLES D. BRICKNER MD
Practice Location Address:

1351 WESTGATE CENTER DR
WINSTON SALEM, NC
27103-2934

Practice Phone: 336-718-7777
Practice Fax: 336-718-7744

1801880174 — RAVI K RAHEJA MD
Practice Location Address:

1351 WESTGATE CENTER DR
WINSTON SALEM, NC
27103-2934

Practice Phone: 336-718-7777
Practice Fax: 336-718-7744

Directions to “ MRS. GWENDOLYN MARY WIGAND BOLLING MD” 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.