Individual
EDWARD B PONTIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
329 BATH RD, BRUNSWICK, ME 04011-2673
(800) 434-3000
Mailing address
329 BATH RD, BRUNSWICK, ME 04011-2673
(800) 434-3000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
015058
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334190099
SERVICING PROVIDER NO.
ME
Enumeration date
11/07/2006
Last updated
07/13/2011
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