Provider Demographics
NPI:1205015534
Name:POL, ARUN ANANDRAO (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:ANANDRAO
Last Name:POL
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 1:6290 ABBOTTS BRIDGE RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8495
Mailing Address - Country:US
Mailing Address - Phone:770-623-8830
Mailing Address - Fax:770-623-8846
Practice Address - Street 1:6290 ABBOTTS BRIDGE RD
Practice Address - Street 2:SUITE 502
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8495
Practice Address - Country:US
Practice Address - Phone:770-623-8830
Practice Address - Fax:770-623-8846
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0399072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H01630Medicare UPIN