Provider Demographics
NPI:1003885526
Name:POLKEY, FAITH LAWRENCE (MD, MPH)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:LAWRENCE
Last Name:POLKEY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 RIBAUT RD
Mailing Address - Street 2:
Mailing Address - City:PORT ROYAL
Mailing Address - State:SC
Mailing Address - Zip Code:29935-1118
Mailing Address - Country:US
Mailing Address - Phone:843-986-0900
Mailing Address - Fax:843-322-1875
Practice Address - Street 1:1320 RIBAUT RD
Practice Address - Street 2:
Practice Address - City:PORT ROYAL
Practice Address - State:SC
Practice Address - Zip Code:29935-1118
Practice Address - Country:US
Practice Address - Phone:843-986-0900
Practice Address - Fax:843-322-1875
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23511208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCH46791Medicare UPIN