Individual
MARIANNA J POULOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1700 SW 7TH ST, TOPEKA, KS 66606-1674
(785) 295-5346
(785) 231-5930
Mailing address
PO BOX 1657, TOPEKA, KS 66601-1657
(785) 295-8108
(785) 231-5991
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
529429
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100412590F
—
KS
Enumeration date
03/09/2006
Last updated
10/27/2009
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