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Individual
POLLY J FERGUSON
Active
Individual
POLLY J FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
2080P0216X
Pediatric Rheumatology Physician
Primary
34521
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0267203
—
IA
01
—
46383
WELLMARK BCBS
IA
Enumeration date
09/19/2005
Last updated
11/30/2007
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