Basic Information
| Provider Information | |||||||||
| NPI: | 1881921534 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POLDERMAN | ||||||||
| FirstName: | KEES | ||||||||
| MiddleName: | HUGO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3550 TERRACE STREET | ||||||||
| Address2: | 6TH FL SCAIFE HALL | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126473136 | ||||||||
| FaxNumber: | 4126478060 | ||||||||
| Practice Location | |||||||||
| Address1: | 3550 TERRACE STREET | ||||||||
| Address2: | 6TH FL SCAIFE HALL | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126473136 | ||||||||
| FaxNumber: | 4126478060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2009 | ||||||||
| LastUpdateDate: | 11/17/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LC0200X | MD438622 | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine |
No ID Information.