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Dr. Donovan C Polack, MD
Nephrology Physician in Florissant, Missouri
NPI 1659324465

Donovan C Polack is a Nephrology Physician based in Florissant, MO and is specialized in Nephrology. Donovan C Polack practices in Florissant, MO and has the professional credentials of MD. The NPI Number for Donovan C Polack is 1659324465 and holds a License No. 036-072078 (Missouri).

The current practice location address for Donovan C Polack is 1265 Graham Rd Ste 1, Florissant, MO and can be reached out via phone at 314-741-1600 and via fax at 314-741-1677.

Location: 1265 Graham Rd Ste 1, Florissant, MO, 63031-8018
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659324465
Provider Name
Donovan C Polack
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1265 Graham Rd Ste 1, Florissant, MO, 63031-8018
Phone Number
314-741-1600
Fax Number
314-741-1677
Provider Enumeration Date
05/19/2006
Last Update Date
06/15/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036072078 05 IL
202546321 05 MO
institution
Provider Business Practice Location Address Details
Address
1265 Graham Rd Ste 1
City
Florissant
State
Missouri
Zip
63031-8018
Phone Number
314-741-1600
Fax Number
314-741-1677
person
Provider Business Mailing Address Details
Address
1265 Graham Rd Ste 1
City
Florissant
State
Missouri
Zip
63031-8018
Phone Number
314-741-1600
Fax Number
314-741-1677
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
R5H69 (Missouri)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Nephrology
Taxonomy
207RN0300X
License No.
036-072078 (Illinois)
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
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