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NPI Code Detail

MEDICARE: DR. ROBERT EDWARD POLEY M.D.

MEDICARE: DR. ROBERT EDWARD POLEY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QS0010XSports Medicine (Family Medicine) Physician35.088761OH
2207QS0010XSports Medicine (Family Medicine) Physician4301081773MI

General Provider Information

NPI Number : 1104038629
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT EDWARD POLEY M.D.
Provider Business Mailing Address
First Line : 1701 SOUTH BLVD E STE 140
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-6118
Country : US
Telephone Number : 248-792-9881
Fax Number : 248-430-5375
Provider Business Practice Location Address
First Line : 1701 SOUTH BLVD E STE 140
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-6118
Country : US
Telephone Number : 248-792-9881
Fax Number : 248-430-5375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 10/22/2021

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Directions to “ DR. ROBERT EDWARD POLEY M.D.” Practice Location

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