Healthcare Provider Details

I. General information

NPI: 1659837896
Provider Name (Legal Business Name): JEFF POLLARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 QUARRY PARK BOULEVARD
CALGARY ALBERTA
T3Z3P3
CA

IV. Provider business mailing address

24137 HERITAGE WOODS DRIVE
CALGARY ALBERTA
T3Z3P3
CA

V. Phone/Fax

Practice location:
  • Phone: 403-210-9960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number012289
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: