Provider Demographics
NPI:1831508993
Name:POLK, CHRISTI
Entity type:Individual
Prefix:
First Name:CHRISTI
Middle Name:
Last Name:POLK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 KENWOOD ST
Mailing Address - Street 2:NOT PROVIDED
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1131
Mailing Address - Country:US
Mailing Address - Phone:248-798-3147
Mailing Address - Fax:
Practice Address - Street 1:3200 KENWOOD ST
Practice Address - Street 2:NOT PROVIDED
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1131
Practice Address - Country:US
Practice Address - Phone:248-798-3147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-03
Last Update Date:2014-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Pathology