Polanco, Marcelo Granado

Polanco, Marcelo Granado is an individual health care provider with primary practice located at 731 S Main St Ste A , Church Point LA 70525. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Polanco, Marcelo Granado can be contacted via phone (337) 684-0911.

Contact Information

Primary practice address
731 S Main St Ste A Church Point LA 70525
Fax: (337) 684-0912
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 023828 Louisiana

Profile Details

NPI number 1982789194
LBN Legal business name Polanco, Marcelo Granado
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Jun 7th, 2011 - about 13 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 1982789194 NPPES
Louisiana MEDICAID 1485438

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