Individual
DMITRIY PODLOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 BRUNSWICK AVE, TRENTON, NJ 08638-4143
(609) 394-6031
Mailing address
750 BRUNSWICK AVE, TRENTON, NJ 08638-4143
(609) 394-6031
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB12408400
NJ
Other
Enumeration date
05/10/2021
Last updated
10/19/2024
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