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Individual

KEITH L PONITZ

Active
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Individual

KEITH L PONITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-065293
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000028325
ANTHEM
OH
01
000000221405
UNISON
OH
01
000000526090
ANTHEM
OH
05
0929599
OH
05
1011566260001
PA
01
200206600A
OK MEDICAID
OK
01
645544
AETNA
OH
01
929599
BCMH
OH
Enumeration date
08/31/2006
Last updated
07/18/2013
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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