Polley, John William

Polley, John William is an individual health care provider with primary practice located at 5085 Anna Dr Ste A , Traverse City MI 49684-7475. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Polley, John William can be contacted via phone (231) 935-0180.

Contact Information

Primary practice address
5085 Anna Dr Ste A Traverse City MI 49684-7475
Phone: (231) 935-0180
Fax: (231) 935-0099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 4301403808 Michigan

Profile Details

NPI number 1477534931
LBN Legal business name Polley, John William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Mar 7th, 2023 - about 3 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 1477534931 NPPES
Illinois MEDICAID 036079739
Illinois Other 0B80405
Illinois Other 21623004

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