Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | 35.088761 | OH |
Y | 207QS0010X | Family Doctor - Sports Medicine | 4301081773 | MI |
NPI | 1104038629 |
---|---|
Provider Name | Dr. Robert Edward Poley |
First Address | Rochester Hills, MI 48307-6118 |
Second Address | Rochester Hills, MI 48307-6118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 22/10/2021 |