Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 2013-00935 | NC |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 54488 | TN |
NPI | 1942437181 |
---|---|
Provider Name | Michael Robert Polin |
First Address | Charlotte, NC 28263-3362 |
Second Address | Knoxville, TN 37920-1510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2009 |
Last Update Date | 16/11/2017 |