Provider Demographics
NPI:1033468889
Name:POLIZZOTTO, MARK N (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:N
Last Name:POLIZZOTTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 10 RM 6N110
Mailing Address - Street 2:9000 ROCKVILLE PIKE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-1838
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BLDG 10 RM 6N110
Practice Address - Street 2:NATIONAL INSTITUTES OF HEALTH, 9000 ROCKVILLE PIKE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1838
Practice Address - Country:US
Practice Address - Phone:301-402-1541
Practice Address - Fax:301-480-5955
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital