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1942283676

NPI Code Detail

MEDICARE: DARRELL MARTIN POLSTER MD

MEDICARE: DARRELL MARTIN POLSTER MD

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
1	207L00000X	Anesthesiology Physician	35084131P	OH
2	207L00000X	Anesthesiology Physician	MD171659	OR
3	207L00000X	Anesthesiology Physician	G88700	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3494801	OTHER		AETNA
3	000000327106	OTHER		ANTHEM BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5781475	OTHER		AETNA

General Provider Information

NPI Number	:	1942283676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRELL MARTIN POLSTER MD

Provider Business Mailing Address
First Line	:	8905 SW NIMBUS AVE
Second Line	:	SUITE 300
City	:	BEAVERTON
State	:	OR
Zip	:	97008-7136
Country	:	US
Telephone Number	:	503-372-2740
Fax Number	:	503-372-2754

Provider Business Practice Location Address
First Line	:	335 SE 8TH AVE
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97123-4246
Country	:	US
Telephone Number	:	503-681-1270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	11/11/2015

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Directions to “ DARRELL MARTIN POLSTER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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