Individual
ROGER POLSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
805 PAMPLICO HWY STE A220, FLORENCE, SC 29505-6056
(843) 674-1530
(843) 673-9098
Mailing address
805 PAMPLICO HWY STE A220, FLORENCE, SC 29505-6056
(843) 674-1530
(843) 673-9098
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19955
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19955
STATE LICENSE
SC
Enumeration date
02/22/2016
Last updated
02/22/2016
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