Provider Demographics
NPI:1558576330
Name:POLLOCK, KARI L (MD)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:L
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:L
Other - Last Name:BJERKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15 S DUPONT HWY
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-7430
Mailing Address - Country:US
Mailing Address - Phone:302-674-1514
Mailing Address - Fax:
Practice Address - Street 1:15 S DUPONT HWY
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-7430
Practice Address - Country:US
Practice Address - Phone:302-674-1514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433198207P00000X
DEC1-0009833207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA210542OtherJOHNS HOPKINS
PA102073214Medicaid
PA2009754OtherHIGHMARK BLUE SHIELD
PA9238152OtherAETNA
PA2009754OtherHIGHMARK BLUE SHIELD
PA9238152OtherAETNA