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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477534931 | NPPES |
| Illinois | MEDICAID | 036079739 | |
| Illinois | Other | 0B80405 | |
| Illinois | Other | 21623004 |
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