Provider Demographics
NPI:1386798528
Name:POLLOCK, WILLIAM M (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15 OMEGA DR
Mailing Address - Street 2:BLDG K
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2057
Mailing Address - Country:US
Mailing Address - Phone:302-454-3040
Mailing Address - Fax:302-454-7733
Practice Address - Street 1:15 OMEGA DR
Practice Address - Street 2:BLDG K
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2057
Practice Address - Country:US
Practice Address - Phone:302-454-3040
Practice Address - Fax:302-454-7733
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10004865208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000740401Medicaid
DE1536348OtherUNITED MINE WORKERS OF AM
DE27491OtherCOVENTRY
DE444663OtherMAMSI
DE1005754OtherCIGNA
DE0192712000OtherAMERIHEALTH
DE444663OtherMAMSI
DE0192712000OtherAMERIHEALTH
DE27491OtherCOVENTRY