Provider Demographics
NPI:1295753382
Name:POLLAK, BRIAN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MICHAEL
Last Name:POLLAK
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-741-8003
Mailing Address - Fax:717-461-7404
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 140
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-741-8003
Practice Address - Fax:717-461-7404
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066596L207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA110793OtherUNISON-WMG
PA1142283OtherAMERIHEALTH MERCY-WMG
PAP002847OtherGATEWAY-WMG
PA172197OtherHIGHMARK BLUE SHIELD
PA7869920OtherAETNA
PA01061501OtherCAPITAL BLUE CROSS-WMG
MD607094OtherCAREFIRST MD BCBS
PA001802970Medicaid
PA0081326000OtherAMERIHEALTH 65 PA
PA280390OtherMAMSI-WMG
PA30123180OtherAMERIHEALTH MERCY - WMG
PA30123297OtherAMERIHEALTH MERCY - WMG
PA039997OtherJOHNS HOPKINS
PA81207OtherGEISINGER
MD607094OtherCAREFIRST MD BCBS
PA039997OtherJOHNS HOPKINS
PA7869920OtherAETNA