Individual
PREETI R POLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
082059
GA
207W00000X
Ophthalmology Physician
81858
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01071747A
INDIANA LICENSE
IN
01
—
036127346
ILLINOIS LICENSE
IL
05
—
036127346
—
IL
05
—
201147260
—
IN
01
—
496710
MEDICARE
IN
01
—
790730006
MEDICARE PTAN
IL
Enumeration date
01/03/2008
Last updated
01/14/2021
Update your record
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