Mccormack, Polly Love

Mccormack, Polly Love is an individual health care provider with primary practice located at 5851 Duluth St Ste 215, Golden Valley MN 55422-3956. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Mccormack, Polly Love can be contacted via phone (763) 546-8422.

Contact Information

Primary practice address
5851 Duluth St Ste 215 Golden Valley MN 55422-3956
Phone: (763) 546-8422
Fax: (763) 546-8114
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 28473 Minnesota

Profile Details

NPI number 1376549089
LBN Legal business name Mccormack, Polly Love
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Apr 23rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376549089 NPPES
Minnesota Other 54817MC BCBS OF MN
Minnesota Other 0818315 BCBS OF MN
Minnesota MEDICAID 967888300 BCBS OF MN
Minnesota Other 180009769 BCBS OF MN

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