Healthcare Provider Details

I. General information

NPI: 1851466734
Provider Name (Legal Business Name): STEVEN ARNOLD POLAKOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2006
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 WISCONSIN AVE 852
CHEVY CHASE MD
20815-4404
US

IV. Provider business mailing address

7008 MOUNTAIN GATE DR
BETHESDA MD
20817-3913
US

V. Phone/Fax

Practice location:
  • Phone: 301-718-0313
  • Fax:
Mailing address:
  • Phone: 301-365-5217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0035104
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberD0035104
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: