Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0127X | Trauma Surgeon | 2018-00123 | NC |
N | 2086S0127X | Trauma Surgeon | 72083 | GA |
Y | 2086S0127X | Trauma Surgeon | DO.2400 | AL |
NPI | 1184898223 |
---|---|
Provider Name | Nathan Michael Polite |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36617-2300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 03/03/2021 |