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Individual

MICHAEL S PONT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
705 DIXIE STREET, CARROLLTON, GA 30117
(770) 834-0751
(770) 834-0753
Mailing address
PO BOX 639219, CINCINNATI, OH 45263-9219
(770) 834-0751
(770) 834-0753

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
035503
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000508637
GA
05
000508637AO
GA
01
P01071675
RAILROAD MEDICARE
GA
Enumeration date
02/16/2006
Last updated
11/08/2017
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