Individual
DR. LOUIS DAVID POTYONDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 PACIFIC AVE, TACOMA, WA 98402-5209
(229) 589-2588
Mailing address
801 PACIFIC AVE, TACOMA, WA 98402-5209
(229) 589-2588
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
057743
GA
208200000X
Plastic Surgery Physician
Primary
MD 60288108
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001281100
—
FL
01
—
1508824293
MEDICARE PRACTICE NPI
GA
05
—
814916866A
—
GA
Enumeration date
05/02/2006
Last updated
09/11/2012
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