Individual
MACIEJ POLTORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7500 HANOVER PKWY, SUITE 201, GREENBELT, MD 20770-2010
(301) 982-7944
(301) 441-8696
Mailing address
7500 HANOVER PKWY, SUITE 201, GREENBELT, MD 20770-2010
(301) 982-7944
(301) 441-8696
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
D54821
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500456
UNITED HEALTHCARE
MD
01
—
16540016
BCBS DC
MD
01
—
298214
MAMSI
MD
01
—
528559
AETNA USHC
MD
05
—
699071100
—
MD
01
—
H832NE
BCBS MD
MD
Enumeration date
08/01/2006
Last updated
06/16/2011
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