| Doctor Name: | DR. MATTHEW ALLEN POLK |
| NPI Number: | 1053574392 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | 0103301039 |
| Business Practice Address: | 83 War Memorial Dr Berkeley Springs, WV - 254111737 |
| Business Phone Number: | 3042580506 |
| Business Fax Number: | 3042580508 |
| Mailing Address: | 83 War Memorial Dr, BERKELEY SPRINGS |
| State: | WV |
| Postal Code: | 254111737 |
| Phone Number: | 3042580506 |
| Fax Number: | 3042580508 |
| NPI Enumeration Date: | 07/07/2008 |
| NPI Last Update Date: | 03/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | 0103301039 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |