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Individual

MARTIN JOHANN PONTASCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
190 HOSPITAL DR, HIGHLANDS, NC 28741-7600
(828) 526-1200
(828) 526-1230
Mailing address
PO BOX 602373, CHARLOTTE, NC 28260-2373
(828) 526-1280
(828) 526-1285

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
35058998P
OH
207P00000X
Emergency Medicine Physician
Primary
036170623
IL
207P00000X
Emergency Medicine Physician
2015-01079
NC
208D00000X
General Practice Physician
ME100079
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000344358
ANTHEM
05
0874406
OH
01
NCS251A
MEDICARE PTAN
NC
01
NCS251A194
MEDICARE PTAN
NC
01
NCS251B
MEDICARE PTAN
NC
Enumeration date
10/05/2006
Last updated
06/27/2024
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