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Individual
DAVID L PONTELL
Active
Individual
DAVID L PONTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103000756
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059115
ANTHEM
—
05
—
09320300
—
VA
01
—
22674
MDIPA OPT CHOICE ALLIANCE
—
01
—
2700107
UNITED HEALTHCARE
—
01
—
3307-0001
CAREFIRST
—
Enumeration date
08/03/2005
Last updated
12/26/2011
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