# JAMES R POLIQUIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1740234335
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 0101033088 | VA | — |
| 2086S0129X | Vascular Surgery Physician | 0101033088 | VA | — |
| 2086S0129X | Vascular Surgery Physician | 42475 | KY | Yes |
| 208C00000X | Colon & Rectal Surgery Physician | 0101033088 | VA | — |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 04/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 020044164 | RAILROAD MEDICARE | — |
| 01 | — | 0582455 | AETNA HMO | — |
| 01 | — | 071140 | ANTHEM | — |
| 01 | — | 1458520 | CIGNA | — |
| 01 | — | 15802 | OPTIMA MEDICAID | VA |
| 01 | — | 213383 | ALLIANCE/MDIPA/MAMSI | — |
| 01 | — | 285008 | SOUTHERN HEALTH | — |
| 01 | — | 4357943 | AETNA PPO/MC | — |
| 05 | — | 7100175390 | — | KY |