Provider Demographics
NPI:1437170891
Name:POLLARD, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:POLLARD
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 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 408
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7363
Mailing Address - Fax:856-968-8288
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 408
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-968-7363
Practice Address - Fax:856-968-8288
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA080959207X00000X
PAMD420079207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1343943OtherAETNA
NJ2624456OtherUNITEDH HEALTHCARE
NJ3K5448OtherHEALTHNET
NJ01077797000OtherAMERICHOICE
PA1898797OtherPA BS HIGHMARK
PA101738836 0001Medicaid
NJ1530368OtherAETNA
NJ5504109OtherCIGNA
NJ60026373OtherHORIZON NJ HEALTH
NJ2767629000OtherAMERIHEALTH/KEYSTONE/IBC
PA2771412000OtherKEYSTON HEALTH PLAN/IBC
NJ0110647Medicaid
NJP3723027OtherOXFORD
NJ60026373OtherHORIZON NJ HEALTH
PA1898797OtherPA BS HIGHMARK
PA105903 QM2Medicare PIN