Provider Demographics
NPI:1952624876
Name:GEORGE N POLIS, MD, PC
Entity Type:Organization
Organization Name:GEORGE N POLIS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:POLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-283-9078
Mailing Address - Street 1:PO BOX 8335
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20195-2235
Mailing Address - Country:US
Mailing Address - Phone:301-801-9750
Mailing Address - Fax:703-348-4127
Practice Address - Street 1:1426 ROSEWOOD HILL DR
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-1484
Practice Address - Country:US
Practice Address - Phone:703-757-0242
Practice Address - Fax:703-348-4127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty