Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25289 | NE |
Y | 207X00000X | Orthopaedic Surgeon | 274200 | MA |
N | 208D00000X | General Practice Physician | 25289 | NE |
NPI | 1043470685 |
---|---|
Provider Name | Dr. Ryan Patrick Ponton |
First Address | Fpo, AE 09617-0002 |
Second Address | Fpo, AE 09617 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 31/07/2018 |