Deborah H Pollock, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9601179 Issued in NC

Practice address

6301 Stadium Dr
Clemmons, NC 27012-8766

Phone

(336) 766-6473

Fax

(336) 766-8909

NPI assigned

Mar 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1609835396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-766-6473",
            "fax_number": "336-766-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 STADIUM DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128766",
            "telephone_number": "336-766-6473",
            "fax_number": "336-766-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "DEBORAH",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9601179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891047N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.