Individual
SHRIHARSH POLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14904 JEFFERSON DAVIS HWY, SUITE 205, WOODBRIDGE, VA 22191-3908
(703) 497-4500
(509) 463-9780
Mailing address
14904 JEFFERSON DAVIS HWY, SUITE 205, WOODBRIDGE, VA 22191-3908
(703) 497-4500
(509) 463-9780
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101048251
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
226798
BLUE CROSS
VA
01
—
2308844
AETNA
VA
05
—
5836166
—
VA
Enumeration date
10/17/2007
Last updated
10/17/2007
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