Individual
MACIEJ POLTORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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