Provider Demographics
NPI:1154304798
Name:POLLARD, MISCHA J (MD)
Entity Type:Individual
Prefix:DR
First Name:MISCHA
Middle Name:J
Last Name:POLLARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:G3245 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3615
Practice Address - Country:US
Practice Address - Phone:810-733-9650
Practice Address - Fax:810-733-9668
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI010B56026OtherBLUE CHOICE
MI0802503062OtherBLUE CROSS BLUE SHIELD
MI010B56026OtherBLUE CARE NETWORK
MI5725531OtherAETNA
MI0980569OtherHEALTH PLUS
MI204389OtherHEALTH ADVANTAGE NETWORK
MI010B56026OtherBLUE CROSS BLUE SHIELD
MI010B56026OtherCOMMUNITY BLUE PPO
MI204389OtherMCLAREN HEALTH PLAN
MIG41799OtherHEALTH NET FEDERAL SERVIC
MI3326375Medicaid
MIG41799OtherHAP
MIG41799Medicare UPIN
MI3326375Medicaid