Provider Demographics
NPI:1740241207
Name:POLAM, UMA (MD)
Entity Type:Individual
Prefix:
First Name:UMA
Middle Name:
Last Name:POLAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 HANOVER PKWY
Mailing Address - Street 2:STE 105B
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2091
Mailing Address - Country:US
Mailing Address - Phone:301-593-8500
Mailing Address - Fax:301-593-7547
Practice Address - Street 1:7500 HANOVER PKWY
Practice Address - Street 2:STE 105B
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2091
Practice Address - Country:US
Practice Address - Phone:301-593-8500
Practice Address - Fax:301-593-7547
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0056496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8102844OtherMDIPA
MD400532500Medicaid
J2770001OtherCAREFIRST BCBS
8102844OtherMDIPA
J2770001OtherCAREFIRST BCBS
DC136602ZBK9Medicare PIN