POLEY SPORTS MEDICINE, PLLC (NPI# 1255832382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255832382 |
| Entity Type | Organization |
| Organization Name | POLEY SPORTS MEDICINE, PLLC |
| Practice Address |
15959 Hall Rd Ste 405 Macomb MI 48044 |
| Mailing Address |
15959 Hall Rd Ste 405 Macomb MI 48044-5368 |
| Practice Telephone | 5864166260 |
| Mailing Telephone | 5864166260 |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-05-25 |
| Authorized Official Name | ROBERT EDWARD POLEY (MANAGING MEMBER) |
| Authorized Official Telephone | 5864166260 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4550 Investment Dr Ste 240, Troy, MI 480986334 | 2487929881 |
| Street Address |
15959 HALL RD STE 405 |
| City | MACOMB |
| State | MI |
| Zip Code | 48044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104038629 | Robert Edward Poley | Family Medicine | 15959 Hall Rd Ste 405, Macomb, MI 48044 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265925788 | Karen Wetzel | Social Worker | 47567 Dennis Baert Dr, Macomb, MI 48044 | 2018-06-09 |
| 1225541956 | Paul John Andary Jr. | Student in an Organized Health Care Education/Training Program | 48599 Penrose Ln, Macomb, MI 48044 | 2017-11-16 |
| 1467972869 | Theresa Lynn Cipponeri | Social Worker | 17937 Hall Road, Macomb, MI 48044 | 2017-06-27 |
| 1407389570 | Nofal Cholag | Pharmacist | 50340 Nesting Ridge Dr, Macomb, MI 48044 | 2017-04-06 |
| 1043754914 | Magdalena Sosnowski | Registered Nurse | 47362 Whippoorwill Dr, Macomb, MI 48044 | 2016-12-13 |
| 1558716894 | Keith Edward Callewaert | Emergency Medical Technician, Paramedic | 48301 Tonawonda Dr, Macomb, MI 48044 | 2016-04-24 |
| 1942684741 | Isabella Scofield | Family Medicine | 46591 Romeo Plank Rd Ste 200, Macomb, MI 48044 | 2015-07-13 |
| 1548600984 | Katie Marie Rosen | Urology | 19991 Hall Rd Ste 201, Macomb, MI 48044 | 2013-06-30 |
| 1699118455 | Kostyantyn Shkilnyy | Massage Therapist | 48254 Ellington Drive, Macomb Township, MI 48044 | 2013-04-11 |
| 1962790097 | Daniel Agrusa | Audiologist | 49306 Flint Ct., Macomb, MI 48044 | 2011-07-11 |
| Find all providers in zip 48044 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669975678 | Shining Light Osteopathic Care Pllc | Clinic/Center | 15300 21 Mile Rd Ste 3, Macomb, MI 48044-5024 | 2018-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684386 | True Women's Clinic of Grand Rapids, PC | Clinic/Center | 2144 E Paris Ave Se Ste 230, Grand Rapids, MI 49546-6111 | 2020-09-18 |
| 1497397202 | Kimberly Wallace Md PC | Clinic/Center | 12900 W 9 Mile Road, Oak Park, MI 48237 | 2019-10-14 |
| 1265081418 | Cherry Street Services Inc | Clinic/Center | 2125 Wrenwood St Sw Ofc Therapist, Wyoming, MI 49519-2362 | 2019-09-10 |
| 1023662079 | J & D Vision Inc | Clinic/Center | 41821 Garfield Rd, Clinton Twp, MI 48038-1965 | 2019-07-29 |
| 1649839945 | Michigan Institute of Sleep Disorders Pllc | Clinic/Center | 7108 Autumn Hill Dr, West Bloomfield, MI 48323-3904 | 2019-06-10 |
| 1447715131 | Ryan Klanseck, Do | Clinic/Center | 16986 Robbins Rd Ste 140, Grand Haven, MI 49417-2795 | 2019-02-06 |
| 1598242455 | Gratiot Advanced Center LLC | Clinic/Center | 7612 Gratiot Ave Ste 200, Detroit, MI 48213-2822 | 2018-07-24 |
| 1902356140 | Midmichigan Pain | Clinic/Center | 2305 Hawthorn Dr, Suite B, Mt Pleasant, MI 48858-1202 | 2016-10-12 |
| 1184085516 | Hester S Pernell Md Pllc | Clinic/Center | 24628 Ridgeview Dr, Farmington Hills, MI 48336-1905 | 2016-03-12 |
| 1275937625 | Innovative Anesthesia Services PC | Clinic/Center | 847 Parchment Dr Se Ste 105, Grand Rapids, MI 49546 | 2014-10-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.