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Individual

DR. LEONARD FLORES POLANCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
217 E ELM ST, GRAHAM, NC 27253-3021
(336) 350-8039
(336) 350-8393
Mailing address
217 E ELM ST, GRAHAM, NC 27253-3021
(336) 350-8039

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
39064
NC
208D00000X
General Practice Physician
Primary
39064
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2149574N
MEDICARE
NC
05
5900679
NC
01
68328
BLUE CROSS BLUE SHIELD OF
NC
Enumeration date
02/22/2006
Last updated
02/22/2021
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