Ponce, Sean Anthony

Ponce, Sean Anthony is an individual health care provider with primary practice located at 3802 S 700 E , Salt Lake City UT 84106-1182. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Ponce, Sean Anthony can be contacted via phone (801) 264-6004.

Contact Information

Primary practice address
3802 S 700 E Salt Lake City UT 84106-1182
Phone: (801) 264-6004
Fax: (801) 264-6098
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 4976571-1205 Utah

Profile Details

NPI number 1376577049
LBN Legal business name Ponce, Sean Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Apr 29th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376577049 NPPES
Utah MEDICAID 1376577049

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