Provider Demographics
NPI:1184827305
Name:POLIC, VJEKOSLAV MARKO (MD)
Entity Type:Individual
Prefix:DR
First Name:VJEKOSLAV
Middle Name:MARKO
Last Name:POLIC
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 1:8903 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4725
Mailing Address - Country:US
Mailing Address - Phone:843-449-3563
Mailing Address - Fax:
Practice Address - Street 1:8903 KINGS RD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4725
Practice Address - Country:US
Practice Address - Phone:843-449-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7708146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant