DR. STEWART MICHAEL POLSKY (NPI# 1881670537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881670537 |
| Entity Type | Individual |
| Full Name | DR. STEWART MICHAEL POLSKY |
| Credential | M.D. |
| Practice Address |
128 Medical Park Rd Suite 301 Mooresville NC 28117-8578 |
| Mailing Address |
9735 Kincey Ave Suite 201 Huntersville NC 28078-9118 |
| Practice Telephone | 7046603322 |
| Practice Fax Number | 7046603330 |
| Mailing Telephone | 7044142870 |
| Mailing Fax Number | 7044142860 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2015-03-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 200200586 | NC | Other Service Providers |
| Y | 208800000X | Urology | 200200586 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 131Y3 | 01 |
| Street Address |
128 MEDICAL PARK RD SUITE 301 |
| City | MOORESVILLE |
| State | NC |
| Zip Code | 28117-8578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619976479 | Sean Michael Fahey | Internal Medicine | 128 Medical Park Rd, Suite 101, Mooresville, NC 28117-8578 | 2005-07-14 |
| 1831218031 | Naomi Soroosh Simon | Dermatology | 128 Medical Park Rd, Suite 201, Mooresville, NC 28117-8578 | 2007-03-28 |
| 1073575908 | Andrea G Brock | Physician Assistant | 128 Medical Park Rd, Suite 101, Mooresville, NC 28117-8578 | 2006-04-05 |
| 1881670164 | David Benjamin Konstandt | Specialist | 128 Medical Park Rd, Suite 301, Mooresville, NC 28117-8578 | 2005-12-19 |
| 1104802859 | Michael Raymond Cram | Specialist | 128 Medical Park Rd, Suite 301, Mooresville, NC 28117-8578 | 2005-12-15 |
| 1750362950 | Manish G Patel | Family Medicine | 128 Medical Park Rd, Suite 101, Mooresville, NC 28117-8578 | 2005-11-07 |
| 1801888797 | Susan Rene Benson | Pediatrics | 128 Medical Park Rd, Ste 200, Mooresville, NC 28117-8578 | 2005-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891356648 | Teleoptometric Service, P.C. | Optometrist | 392 Talbert Rd, Mooresville, NC 28117 | 2019-06-24 |
| 1992268544 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 392 Talbert Rd., Mooresville, NC 28117 | 2019-04-10 |
| 1982178042 | Langtree Endoscopy Center, LLC | Clinic/Center | 106 Alexander Bank Drive, Suite 101, Mooresville, NC 28117 | 2019-01-11 |
| 1679044416 | May and Associates Therapy Center | Psychologist | 862 Brawley School Road, Suite 202, Mooresville, NC 28117 | 2018-12-05 |
| 1700360153 | Sabrina Chabot Hutchinson | Physical Therapist | 508 Williamson Rd, Suite 200, Mooresville, NC 28117 | 2018-09-21 |
| 1992284327 | Presbyterian Imaging Centers LLC | Radiology | 106 Langtree Village Dr # 201, Mooresville, NC 28117 | 2018-08-07 |
| 1073091310 | Jenelle Donzelli Nemeth | Registered Nurse | 102 Sapphire Drive, Mooresville, NC 28117 | 2018-07-30 |
| 1912497496 | Patsharx LLC | Pharmacy | 480 River Hwy, Suite A, Mooresville, NC 28117 | 2018-05-10 |
| 1427502434 | Counseling Service At Lake Norman, Pllc | Community/Behavioral Health | 18117 W. Catawba Avenue, Cornelius, NC 28117 | 2016-08-08 |
| 1447605928 | Renewal Counseling, Pllc | Counselor | 125 Commerce Park Rd., Suite 102, Mooresville, NC 28117 | 2016-05-03 |
| Find all providers in zip 28117 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356500177 | Novant Medical Group, Inc. | Urology | 131 Medical Park Rd, Suite 305, Mooresville, NC 28117-8522 | 2008-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528673423 | Meredith Abernethy | Urology | 140 Kimel Park Dr # 100, Winston Salem, NC 27103-6184 | 2020-09-09 |
| 1942833678 | Joshua Daniel Howell | Urology | 10650 Park Rd Ste 320, Charlotte, NC 28210-8543 | 2020-02-21 |
| 1144887019 | Shuo Liu | Urology | Department of Urology Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2019-05-25 |
| 1427563725 | Hifu Prostate Services, LLC | Urology | 4108 Park Rd Ste 205, Charlotte, NC 28209-2260 | 2017-12-08 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1184163883 | Dlp Central Carolina Medical Group LLC | Urology | 1139 Carthage St Ste 110-b, Sanford, NC 27330-4111 | 2017-02-15 |
| 1578007225 | Cumberland County Hospital System Inc | Urology | 805 Tilghman Dr, Suite A, Dunn, NC 28334-5887 | 2016-12-15 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1588019152 | Murphy Medical Center, Inc. | Urology | 75 Medical Park Ln Ste A, Murphy, NC 28906-6673 | 2016-05-02 |
| 1427446723 | Regional Physicians LLC | Urology | 217- 218 Gatewood Ave, High Point, NC 27262-4877 | 2015-01-08 |
| Find all providers with the same taxonomy | ||||
| City | MOORESVILLE |
| Zip Code | 28117 |
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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.