Individual
DR. EDWARD PHILLIPS POLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL PARK, SUITE 704, WHEELING, WV 26003
(304) 243-3134
(304) 243-3834
Mailing address
1 MEDICAL PARK, SUITE 704, WHEELING, WV 26003
(304) 243-3134
(304) 243-3834
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
11955
WV
2086S0105X
Surgery of the Hand (Surgery) Physician
35047399
OH
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
11955
WV
2086S0122X
Plastic and Reconstructive Surgery Physician
35047399
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114270000
—
WV
05
—
0415214
—
OH
01
—
11955
HMO
—
Enumeration date
09/16/2005
Last updated
06/03/2020
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