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General NPI Number Information
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NPI Number | 1356311146
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Entity Type | Individual
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Provider Name | MARIE E POLLARD MPAS, PA/C
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Gender | Female
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 12/03/2009
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Provider Practice Location Address
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Address Line | 9501 FARRELL RD
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City | FORT BELVOIR
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State | VA
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Zip | 22060-5901
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Country | US
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Telephone | 703-805-0903
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Fax |
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Provider Business Mailing Address
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Address Line | 17959 SWANS CREEK LN
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City | DUMFRIES
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State | VA
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Zip | 22026-4528
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Country | US
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Telephone | 703-441-0262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110001152
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License Number State | VA
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