Michael K Polnerow, D.O.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

C2-0002419 Issued in DE

Practice address

701 N Clayton St Ste 401
St. Francis Medical Services Building
Wilmington, DE 19805-3165

Phone

(302) 421-9411

Fax

(302) 421-9460

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1881680023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 OGLETOWN STANTON RD",
            "address_2": "SUITE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132081",
            "telephone_number": "302-225-0451",
            "fax_number": "302-225-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N CLAYTON ST STE 401",
            "address_2": "ST. FRANCIS MEDICAL SERVICES BUILDING",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053165",
            "telephone_number": "302-421-9411",
            "fax_number": "302-421-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLNEROW",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "DE",
            "license": "C2-0002419",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "H0038383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526271200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000104503",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8818606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark William Polimeno, PHARMD
• Tracy Croswell Polk, MSW
• Katherine Douglass Pollack, OTD, OTR/L, ATACP
• Catherine Pollard
• Amanda Kristine Pollock
• Alexandra Sabrina Polon, PT, DPT
• Supritha Nagaraj Polubothu, DPT
• Anamiguel Pomales-Ramos
• Kara Lynn Pomicter, ATC
• Emily Pomrinca, LPCMH

• Nephrology Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Nephrology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.