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Individual
SAMUEL PONIACHIK
Active
Individual
SAMUEL PONIACHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G74757
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CT483X
PTAN
CA
01
—
W14158
GROUP PTAN
CA
Enumeration date
07/08/2006
Last updated
07/18/2013
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