MEDICARE: DR. LAURENCE B POLSKY 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	207V00000X	Obstetrics & Gynecology Physician	D0050213	MD

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

General Provider Information

NPI Number	:	1952473845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURENCE B POLSKY MD

Provider Business Mailing Address
First Line	:	975 SOLOMONS ISLAND RD N
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3917
Country	:	US
Telephone Number	:	410-535-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 SOLOMONS ISLAND RD N
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3917
Country	:	US
Telephone Number	:	410-535-5400
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	01/22/2021

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Directions to “ DR. LAURENCE B POLSKY MD” Practice Location

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