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NPI Code Detail

MEDICARE: FAITH LAWRENCE POLKEY M.D., M.P.H.

MEDICARE: FAITH LAWRENCE POLKEY M.D., M.P.H.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician23511SC

General Provider Information

NPI Number : 1003885526
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAITH LAWRENCE POLKEY M.D., M.P.H.
Provider Business Mailing Address
First Line : 1320 RIBAUT RD
Second Line :
City : PORT ROYAL
State : SC
Zip : 29935-1118
Country : US
Telephone Number : 843-986-0900
Fax Number : 843-322-1875
Provider Business Practice Location Address
First Line : 1320 RIBAUT RD
Second Line :
City : PORT ROYAL
State : SC
Zip : 29935-1118
Country : US
Telephone Number : 843-986-0900
Fax Number : 843-322-1875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 03/10/2020

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