Healthcare Provider Details

I. General information

NPI: 1407846728
Provider Name (Legal Business Name): MATTHEW E POLLARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 E LOHMAN AVE STE 301
LAS CRUCES NM
88011-8262
US

IV. Provider business mailing address

3145 ROCKS FARM CT
CHARLOTTESVILLE VA
22903-9323
US

V. Phone/Fax

Practice location:
  • Phone: 434-466-2346
  • Fax:
Mailing address:
  • Phone: 434-466-2346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number0101234693
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberMD.44016
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: