Provider Demographics
NPI:1851331409
Name:POLLOCK, JAMES ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERIC
Last Name:POLLOCK
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 1:14338 CHESTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1923
Mailing Address - Country:US
Mailing Address - Phone:301-871-9185
Mailing Address - Fax:
Practice Address - Street 1:8118 GOOD LUCK RD
Practice Address - Street 2:8118 GOODLUCK RD
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3595
Practice Address - Country:US
Practice Address - Phone:301-552-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0030858207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E40047Medicare UPIN
DC000279D14Medicare PIN