Individual
KENNETH POLEZOES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7310 W LINCOLN HWY, CROWN POINT, IN 46307-9528
(219) 322-4637
(219) 322-5298
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01082274A
IN
208M00000X
Hospitalist Physician
01082274A
IN
Other
Enumeration date
06/04/2016
Last updated
10/16/2023
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