Individual
THEODORE G PANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
45 WARNER RD, GROSSE POINTE FARMS, MI 48236
(313) 881-5612
Mailing address
45 WARNER RD, GROSSE POINTE FARMS, MI 48236
(313) 881-5612
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301023016
MI
Other
Enumeration date
05/09/2007
Last updated
08/03/2012
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