Provider Demographics
NPI:1912984295
Name:POLIN, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:POLIN
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 1:3801 BELLEMEADE AVE
Mailing Address - Street 2:SUITE 200C
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0100
Mailing Address - Country:US
Mailing Address - Phone:812-485-1797
Mailing Address - Fax:812-485-1713
Practice Address - Street 1:3801 BELLEMEADE AVE
Practice Address - Street 2:SUITE 200C
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0100
Practice Address - Country:US
Practice Address - Phone:812-485-1797
Practice Address - Fax:812-485-1713
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031593A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000245661OtherBCBS
110245034OtherRAILROAD MEDICARE
04367929402OtherDONLEY & CO.
130227OtherHEALTHLINK
043679294006OtherUNICARE
IN100358040Medicaid
068094OtherHEALTH ALLIANCE
110245034OtherRAILROAD MEDICARE
C25867Medicare UPIN