Individual
BRADFORD S PONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8316 ARLINGTON BLVD, SUITE 310, FAIRFAX, VA 22031-5207
(703) 641-0333
(703) 573-3316
Mailing address
8316 ARLINGTON BLVD, SUITE 310, FAIRFAX, VA 22031-5207
(703) 641-0333
(703) 573-3316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101055063
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010132754
—
VA
01
—
114536
ANTHEM BC/BS
VI
01
—
25790006
CAREFIRST BC/BS
VA
Enumeration date
03/20/2006
Last updated
07/08/2007
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