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Individual
MIKE POLEWSKI
Active
Individual
MIKE POLEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
5601009538
MI
2084P0800X
Psychiatry Physician
5601009538
MI
363A00000X
Physician Assistant
5601009538
MI
Other
Enumeration date
07/29/2019
Last updated
02/24/2024
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