Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0101040519 | VA |
Y | 111NI0900X | Internist | 0101040519 | VA |
N | 207RN0300X | Nephrologist | 0101040519 | VA |
NPI | 1033184379 |
---|---|
Provider Name | Paul J Pontier |
First Address | Chesapeake, VA 23321-5260 |
Second Address | Chesapeake, VA 23320-1614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 12/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010109931 | (05) | VA |
147258 | ANTHEM (01) | VA |
16539 | SENTARA/OPTIMA (01) | VA |
5040715 | AETNA (01) | VA |
541595397 | CIGNA (01) | VA |
541595397 | MID ATLANTIC SOLUTIONS (01) | VA |
541595397 | PRIVATE HEALTHCARE SYSTEM (01) | VA |
541595397 | TRICARE (01) | VA |
541595397 | VIRGINIA HEALTH NETWORK (01) | VA |
F35419 | (02) | VA |