Provider Demographics
NPI:1154396992
Name:POLGAR, JEFFREY ROBERT (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ROBERT
Last Name:POLGAR
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:PO BOX 1240
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-1240
Mailing Address - Country:US
Mailing Address - Phone:828-678-9352
Mailing Address - Fax:828-682-7866
Practice Address - Street 1:2 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-2929
Practice Address - Country:US
Practice Address - Phone:828-678-9352
Practice Address - Fax:828-682-7866
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300681207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00370104OtherRAILROAD MEDICARE PTAN
NC89135V9Medicaid
NC135V9OtherBCBS NC
NC2031967AOtherMEDICARE PIN
NC135V9OtherBCBS NC