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Contact Information

JUSTIN BOLIN
615 S NEW BALLAS RD
SAINT LOUIS, MO63141-8221
 Phone: 314-251-7921
 Fax: 314-251-4815
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diabetes Educator

163WD0400X
Indicates primary specialty

NPI Profile & details for JUSTIN BOLIN · (Male)

NPI Number 1225527633
Status Active
Credentials
Entity Individual
Enumeration date 05/02/2018
Last updated 05/02/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2015024051
  • Other 21800005 NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS
  • MO Other 2015024051 MISSOURI STATE BOARD OF NURSING
Hospital affiliation(s) Not Available
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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