MEDICARE: DR. ALAN J POLLACK 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	207W00000X	Ophthalmology Physician	0101225387	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	286919	OTHER	MAMSI/ALLIANCE
2	140021	OTHER	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	A937-0002	OTHER	CAREFIRST
5	7125122	OTHER	AETNA PPO
6	345382	OTHER	NCPPO
7	540947194	OTHER	UNITED HEALTH
8	2391760	OTHER	AETNA HMO

General Provider Information

NPI Number	:	1629063052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN J POLLACK MD

Provider Business Mailing Address
First Line	:	4660 KENMORE AVE
Second Line	:	SUITE 416
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1313
Country	:	US
Telephone Number	:	703-751-0700
Fax Number	:	703-751-2020

Provider Business Practice Location Address
First Line	:	4660 KENMORE AVE
Second Line	:	SUITE 416
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1313
Country	:	US
Telephone Number	:	703-751-0700
Fax Number	:	703-751-2020

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	07/09/2010

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