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Individual

PAUL J PONTIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
713 VOLVO PKWY, STE 100, CHESAPEAKE, VA 23320-1614
(757) 548-0076
(757) 548-1652
Mailing address
3241 WESTERN BRANCH BLVD, CHESAPEAKE, VA 23321-5260
(757) 686-3508
(757) 686-0541

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101040519
VA
207RN0300X
Nephrology Physician
0101040519
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010109931
VA
01
147258
ANTHEM
VA
01
16539
SENTARA/OPTIMA
VA
01
5040715
AETNA
VA
01
541595397
MID ATLANTIC SOLUTIONS
VA
Enumeration date
02/21/2006
Last updated
04/12/2010
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