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1043218324

NPI Code Detail

MEDICARE: CHRISTOPHER J POGLIANO MD

MEDICARE: CHRISTOPHER J POGLIANO MD

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
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	4301045631	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1018474	OTHER		PREFERREDONE
4	CP045631	OTHER	MI	BLUE CROSS BLUE SHIELD MI
5	12D79PO	OTHER	MN	BCBS

General Provider Information

NPI Number	:	1043218324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER J POGLIANO MD

Provider Business Mailing Address
First Line	:	N10565 GRANDVIEW LN
Second Line	:
City	:	IRONWOOD
State	:	MI
Zip	:	49938-9622
Country	:	US
Telephone Number	:	906-932-1500
Fax Number	:	906-932-5630

Provider Business Practice Location Address
First Line	:	N10565 GRANDVIEW LN
Second Line	:
City	:	IRONWOOD
State	:	MI
Zip	:	49938-9622
Country	:	US
Telephone Number	:	906-932-1500
Fax Number	:	906-932-5091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	04/07/2010

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Directions to “ CHRISTOPHER J POGLIANO MD” Practice Location

Language	Start Address	Practice Location

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