Theodore Z Polley
Surgeon Pediatric Surgery Surgical Critical Care
5301 East Huron River Dr
Ypsilanti
, Michigan 48197-1051
Theodore Z Polley
Surgeon Pediatric Surgery Surgical Critical Care
5301 East Huron River Dr
Ypsilanti
, Michigan 48197-1051
(734) 936-2047
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About
Features
Specialties
- Surgeon
- Surgical Critical Care
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Theodore Z Polley
- 3621 S State St 700 Kms Place
- Ann Arbor, MI
- Zip : 48108
- Phone : (734) 936-2047
Second Address
- Theodore Z Polley
- 5301 East Huron River Dr
- Ypsilanti, MI
- Zip : 48197-1051
- Phone : (734) 712-2441
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 4301036361 | MI |
| N | 208600000X | Surgeon | 4301036361 | MI |
| N | 2086S0102X | Surgical Critical Care | 4301036361 | MI |
| Y | 2086S0120X | Pediatric Surgery | 4301036361 | MI |
National Provider Identifier
| NPI | 1326140658 |
|---|---|
| Provider Name | Theodore Z Polley |
| First Address | Ann Arbor, MI 48108 |
| Second Address | Ypsilanti, MI 48197-1051 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/09/2006 |
| Last Update Date | 02/07/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1407812 | (05) | MI |
| A78769 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.