Healthcare Provider Details

I. General information

NPI: 1407589484
Provider Name (Legal Business Name): POLLARA A COBB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: POLLARA ANTONIA B COBB

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

8005 13TH ST APT 102
SILVER SPRING MD
20910-5830
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4664
  • Fax:
Mailing address:
  • Phone: 404-632-4895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: