Polidore, Thomas Michael

Polidore, Thomas Michael is an sole proprietor health care provider with primary practice located at 3 Medical Plaza Dr Ste 130 , Roseville CA 95661-3088. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Polidore, Thomas Michael can be contacted via phone (916) 773-8750.

Contact Information

Primary practice address
3 Medical Plaza Dr Ste 130 Roseville CA 95661-3088
Phone: (916) 773-8750
Fax: (916) 797-4774
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X G83054 California
Allopathic & Osteopathic Physicians / Surgery 208600000X G83054 California

Profile Details

NPI number 1366424095
LBN Legal business name Polidore, Thomas Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 17th, 2005
Last updated Jan 11th, 2018 - about 7 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 1366424095 NPPES
California MEDICAID OOG830540

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