National Provider Identifier Database

RANDALL J BOLAR, MD – NPI #1558323246
Surgery

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.


Contact Information

RANDALL J BOLAR, MD
1027 WASHINGTON AVE
DETROIT LAKES, MN56501-3409
Phone: 218-847-5611
Fax: 218-847-0881
Website:
Specialty Taxonomy Code
* Surgery 208600000X

* Indicates primary specialty

NPI Profile & details for RANDALL J BOLAR

NPI Number 1558323246
Credentials MD
Entity Individual
Enumeration date 04/06/2006
Last updated 12/23/2015 - About 10 years ago
Sole proprietor1 No
Identifiers
  • MN License #: 36945
  • TN License #: 34949
  • KY Medicaid: 64357130
  • MN Medicaid: 1558323246
  • TN Medicaid: 1515147
  • TN Medicaid: 3338849
  • Other: 10802394 CAQH
  • KY Other: 7774037 AETNA
  • KY Other: 000000069481 ANTHEM BC
  • TN Other: TN0125 AMERICHOICE
  • TN Other: 01281517 AMERIGROUP
  • TN Other: 4221186 BCBS
  • TN Other: 203500913011 TRICARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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