Individual
COLE MATTHEW POLNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
7900 W JEFFERSON BLVD STE 306, FORT WAYNE, IN 46804-4128
(260) 458-3610
(260) 458-3611
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004299A
IN
Other
Enumeration date
01/03/2024
Last updated
08/14/2024
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