Provider Demographics
NPI:1285731620
Name:POLSKY, FRED IRWIN (MD)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:IRWIN
Last Name:POLSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4100 CATHEDRAL AVE NW
Mailing Address - Street 2:APT. PH-16
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3584
Mailing Address - Country:US
Mailing Address - Phone:202-237-1224
Mailing Address - Fax:202-686-2595
Practice Address - Street 1:4100 CATHEDRAL AVE NW
Practice Address - Street 2:APT. PH-16
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3584
Practice Address - Country:US
Practice Address - Phone:202-237-1224
Practice Address - Fax:202-686-2595
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD035904207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology