Polley, Theodore Z

Polley, Theodore Z is an individual health care provider with primary practice located at 5301 East Huron River Dr , Ypsilanti MI 48197-1051. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is his primary health care specialty. Polley, Theodore Z can be contacted via phone (734) 712-2441.

Contact Information

Primary practice address
5301 East Huron River Dr Ypsilanti MI 48197-1051
Phone: (734) 712-2441
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301036361 Michigan
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 4301036361 Michigan
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 4301036361 Michigan

Profile Details

NPI number 1326140658
LBN Legal business name Polley, Theodore Z
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2006
Last updated Jul 2nd, 2012 - 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 1326140658 NPPES
Michigan MEDICAID 1407812

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