Individual
MICHAEL K POLNEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
701 N CLAYTON ST STE 401, ST. FRANCIS MEDICAL SERVICES BUILDING, WILMINGTON, DE 19805-3165
(302) 421-9411
(302) 421-9460
Mailing address
4923 OGLETOWN STANTON RD, SUITE 200, NEWARK, DE 19713-2081
(302) 225-0451
(302) 225-0472
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
C2-0002419
DE
207RN0300X
Nephrology Physician
H0038383
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000104503
—
DE
05
—
526271200
—
MD
05
—
8818606
—
NJ
Enumeration date
09/22/2005
Last updated
06/15/2011
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