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Individual

GLENN M POLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4145
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4145

Taxonomy

Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
22453
MS
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD.205625
LA
207RC0001X
Clinical Cardiac Electrophysiology Physician
MT047804
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT047804
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05733746
MS
05
2303457
LA
Enumeration date
07/10/2008
Last updated
09/04/2018
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