Individual
DR. MATTHEW R. POLLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28866
SC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
28866
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288664
—
SC
01
—
P00883441
RR MEDICARE ID
SC
05
—
PA4646
—
SC
Enumeration date
10/18/2006
Last updated
12/01/2021
Update your record
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