Provider Demographics
NPI:1205602034
Name:POLLER, WOLFRAM CHRISTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:WOLFRAM
Middle Name:CHRISTIAN
Last Name:POLLER
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 1:363 E 157TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4422
Mailing Address - Country:US
Mailing Address - Phone:857-389-2073
Mailing Address - Fax:
Practice Address - Street 1:CHARITEPLATZ 1
Practice Address - Street 2:DHZC
Practice Address - City:BERLIN
Practice Address - State:BERLIN
Practice Address - Zip Code:10117
Practice Address - Country:DE
Practice Address - Phone:857-389-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZXXX207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease