Organization
POLLEY CLINIC OF DERMATOLOGY & DERMATOLOGIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI NEWMAN (CREDENTIALING SPECIALIST)
(252) 668-7026
Entity
Organization
Contact information
Practice address
1806 GLENDALE DR SW, WILSON, NC 27893-4402
(252) 243-0566
(252) 243-1347
Mailing address
1806 GLENDALE DR SW, WILSON, NC 27893-4402
(252) 243-0566
(252) 243-1347
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
27881
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0296G
BCBS OF NC
NC
01
—
2222414
FIRST HEALTH
NC
01
—
68327
ACCORDIA
NC
01
—
7068303
CIGNA
NC
01
—
7257619
AETNA
NC
01
—
785505
UNITED HEALTH CARE
NC
05
—
890296G
—
NC
01
—
99494
MEDCOST
NC
01
—
DE4848
RAIL ROAD MEDICARE
NC
Enumeration date
07/21/2006
Last updated
08/04/2021
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