Polka, Michael D

Polka, Michael D is an individual health care provider with primary practice located at 1818 N Meade St , Appleton WI 54911-3454. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Polka, Michael D can be contacted via phone (920) 731-4101.

Contact Information

Primary practice address
1818 N Meade St Appleton WI 54911-3454
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-108682 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 53394 Wisconsin

Profile Details

NPI number 1144242223
LBN Legal business name Polka, Michael D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Feb 9th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144242223 NPPES
Illinois MEDICAID 036108682
Illinois MEDICAID 34715700
Illinois Other P00054858

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