Individual
DESMOND RECARDO PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5010 CAROLINA FOREST BLVD, MYRTLE BEACH, SC 29579-3579
(843) 236-2700
(843) 236-2726
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86042
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
860429
—
SC
Enumeration date
04/23/2021
Last updated
08/07/2024
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