Organization
DR POKOVS POLYCLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER POKOV MD (PRESIDENT)
(410) 358-9158
Entity
Organization
Contact information
Practice address
6821 REISTERSTOWN RD, SUITE #206, BALTIMORE, MD 21215
(410) 358-9158
(410) 358-6350
Mailing address
6821 REISTERSTOWN RD, SUITE #206, BALTIMORE, MD 21215
(410) 358-9158
(410) 358-6350
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0054746
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P64
BLUE CROSS BLUE SHIELD
MD
05
—
682505200
—
MD
Enumeration date
07/28/2006
Last updated
11/27/2012
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