Provider Demographics
NPI:1760643597
Name:POLOMSKY, MATEJ (MD)
Entity Type:Individual
Prefix:
First Name:MATEJ
Middle Name:
Last Name:POLOMSKY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1729 NEW HANOVER MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5345
Mailing Address - Country:US
Mailing Address - Phone:910-763-3601
Mailing Address - Fax:
Practice Address - Street 1:1729 NEW HANOVER MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5345
Practice Address - Country:US
Practice Address - Phone:910-763-3601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-00131207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology