Provider Demographics
NPI:1356784987
Name:DOUGLAS W POLLARD
Entity type:Organization
Organization Name:DOUGLAS W POLLARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:734-629-3175
Mailing Address - Street 1:31422 SETTLERS WAY DR
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:MI
Mailing Address - Zip Code:48134-3332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31422 SETTLERS WAY DR
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:MI
Practice Address - Zip Code:48134-3332
Practice Address - Country:US
Practice Address - Phone:734-629-3175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health