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NPI Code Detail

MEDICARE: DR. POLLY J. HINEMAN D.O.

MEDICARE: DR. POLLY J. HINEMAN D.O.
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
1207R00000XInternal Medicine Physician02103IA

General Provider Information

NPI Number : 1376527606
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. POLLY J. HINEMAN D.O.
Provider Business Mailing Address
First Line : 401 1ST AVE
Second Line :
City : TOLEDO
State : IA
Zip : 52342-2129
Country : US
Telephone Number : 641-484-2602
Fax Number : 641-484-6837
Provider Business Practice Location Address
First Line : 401 1ST AVE
Second Line :
City : TOLEDO
State : IA
Zip : 52342-2129
Country : US
Telephone Number : 641-484-2602
Fax Number : 641-484-6837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 08/31/2016

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