Provider Demographics
NPI:1871510339
Name:POLLARD, MARCUS L (MD)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:L
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 1:700 BELLEVUE ST SE
Mailing Address - Street 2:STE 225
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3819
Mailing Address - Country:US
Mailing Address - Phone:503-485-0397
Mailing Address - Fax:503-485-0399
Practice Address - Street 1:700 BELLEVUE ST SE
Practice Address - Street 2:STE 225
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3819
Practice Address - Country:US
Practice Address - Phone:503-485-0397
Practice Address - Fax:503-485-0399
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14707207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR174920Medicaid
OR174920Medicaid
D34313Medicare UPIN