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Individual

DR. PHILIP WADE PONDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
114 CHARLOIS BLVD, WINSTON-SALEM, NC 27103-1522
(336) 765-5470
(336) 765-5428
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 765-5470
(336) 765-5428

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35818
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8968393
NC
Enumeration date
06/04/2006
Last updated
08/23/2022
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