Polen, Thomas Alan

Polen, Thomas Alan is an individual health care provider with primary practice located at 845 82Nd Pkwy , Myrtle Beach SC 29572-4614. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Polen, Thomas Alan can be contacted via phone (843) 449-9621.

Contact Information

Primary practice address
845 82Nd Pkwy Myrtle Beach SC 29572-4614
Phone: (843) 449-9621
Fax: (843) 449-4921
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 9075 South Carolina

Profile Details

NPI number 1215913090
LBN Legal business name Polen, Thomas Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Mar 22nd, 2010 - about 15 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 1215913090 NPPES
South Carolina MEDICAID 090751

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