Healthcare Provider Details

I. General information

NPI: 1851331409
Provider Name (Legal Business Name): JAMES ERIC POLLOCK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 GOOD LUCK RD 8118 GOODLUCK RD
LANHAM MD
20706-3595
US

IV. Provider business mailing address

14338 CHESTERFIELD RD
ROCKVILLE MD
20853-1923
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-8665
  • Fax:
Mailing address:
  • Phone: 301-871-9185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0030858
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: