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Organization
RAYMOND M PONGONIS DO, INC.
Active
Organization
RAYMOND M PONGONIS DO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND M PONGONIS D.O. (PRESIDENT)
(614) 875-8315
Entity
Organization
Contact information
Practice address
2407 SPORTSMAN DR, GROVE CITY, OH 43123-3987
(614) 875-8315
(614) 875-8328
Mailing address
2407 SPORTSMAN DR, GROVE CITY, OH 43123-3987
(614) 875-8315
(614) 875-8328
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34003156
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0213307
—
OH
Enumeration date
03/23/2006
Last updated
11/20/2012
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