Provider Demographics
NPI:1740454875
Name:POLITE, ADRIENNE NICOLE (DO)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:NICOLE
Last Name:POLITE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:NICOLE
Other - Last Name:METTERNICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1605 ROBERTA DR SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-3855
Mailing Address - Country:US
Mailing Address - Phone:770-419-3120
Mailing Address - Fax:
Practice Address - Street 1:1605 ROBERTA DR SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-3855
Practice Address - Country:US
Practice Address - Phone:770-419-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA72417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine