Polk, Walter Earl

Polk, Walter Earl is an individual health care provider with primary practice located at 543 Country Ridge Circle , Bel Air MD 21015. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Polk, Walter Earl can be contacted via phone (410) 569-0007.

Contact Information

Primary practice address
543 Country Ridge Circle Bel Air MD 21015
Fax: (410) 569-3738
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1526 Maryland
Behavioral Health & Social Service Providers / Clinical 103TC0700X 01526 Maryland

Profile Details

NPI number 1376551291
LBN Legal business name Polk, Walter Earl
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Mar 1st, 2022 - about 2 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 1376551291 NPPES
Maryland MEDICAID 189931700

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