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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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