IndividualActive
Gerald Polukoff, MD
NPI 1215020045 · Cardiovascular Disease Physician · Logan, UT
Provider details
- NPI number
- 1215020045
- Entity type
- Individual
- Primary specialty
- Cardiovascular Disease PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 370398-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1300 N 500 E
Logan, UT 84341-2408
Phone: (435) 716-2200
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 27128
Salt Lake City, UT 84127-0128
Registry dates
- Enumerated
- 2006-10-02
- Last updated
- 2016-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.