Individual
SERGIO PONZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
G1071 N BALLENGER HWY, SUITE 310, FLINT, MI 48504-4453
(810) 238-4172
(810) 238-4153
Mailing address
8355 JACLYN ANN DR, FLUSHING, MI 48433-2910
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301036859
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311260010
—
MI
Enumeration date
10/25/2005
Last updated
05/03/2012
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