Individual
ELIZABETH POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
46 WESLEY RD, DALEVILLE, VA 24083-3082
(540) 992-4100
Mailing address
2724 CRYSTAL SPRING AVE SW, ROANOKE, VA 24014-2322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101-055456
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005636655
—
VA
05
—
5637783
—
VA
05
—
5637791
—
VA
Enumeration date
02/03/2006
Last updated
08/11/2011
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