Individual
AIDA B. PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
144 N FROST DR, SUITE 4, SAGINAW, MI 48638-7186
(989) 790-7665
(989) 790-9147
Mailing address
144 N FROST DR, SUITE 4, SAGINAW, MI 48638-7186
(989) 790-7665
(989) 790-9147
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ABP040553
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400553
HEALTH PLUS ID #
MI
05
—
1587050
—
MI
01
—
3507333702
BLUE CROSS ID#
MI
01
—
P60002
BLUE CARE NETWORK ID#
MI
Enumeration date
05/09/2006
Last updated
03/31/2021
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