Mary-Anne Angeline Polan, OTR

Primary specialty

SpecialistTaxonomy code 174400000X

License

5201001745 Issued in MI

Practice address

22550 Hall Rd
Clinton Township, MI 48036-1189

Phone

(586) 466-7904

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1285773739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39475 LAKESHORE DR",
            "city": "HARRISON TOWNSHIP",
            "state": "MI",
            "postal_code": "480451863",
            "telephone_number": "586-465-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22550 HALL RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480361189",
            "telephone_number": "586-466-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAN",
        "first_name": "MARY-ANNE",
        "middle_name": "ANGELINE",
        "name_prefix": "Prof.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MI",
            "license": "5201001745",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "5201001745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Goodharbor Platt-Koch, DO
• Renee Marie Plegue, MOT,OTR
• Robert Thomas Plunkett, DDS,MS
• Laurie Ann Pocius
• Erica Rae Podsiadly, BA
• Guillermo Polanco Serra, MD
• Mike Polewski, PA
• John Polyzois, DO
• Leon Popaj, MD
• Haley Melissa Pope, DO

• Specialist in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.