| Doctor Name: | PAULA BOLAND |
| NPI Number: | 1336566157 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 37183 |
| Business Practice Address: | 370 Log Branch Rd Bamberg, SC - 29003 |
| Business Phone Number: | 8032455176 |
| Business Fax Number: | |
| Mailing Address: | 370 Log Branch Rd, BAMBERG |
| State: | SC |
| Postal Code: | 290038462 |
| Phone Number: | 8032455176 |
| Fax Number: | |
| NPI Enumeration Date: | 03/19/2014 |
| NPI Last Update Date: | 03/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | 37183 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |