Pontell, David L

Pontell, David L is an individual health care provider with primary practice located at 3025 Hamaker Ct #340, Fairfax VA 22031-2237. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Pontell, David L can be contacted via phone (703) 849-8400.

Contact Information

Primary practice address
3025 Hamaker Ct #340 Fairfax VA 22031-2237
Phone: (703) 849-8400
Fax: (703) 849-8448
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0103000756 Virginia

Profile Details

NPI number 1457352239
LBN Legal business name Pontell, David L
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Dec 26th, 2011 - about 13 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 1457352239 NPPES
Other 059115 ANTHEM
Other 3307-0001 ANTHEM
Other 22674 ANTHEM
Other 2700107 ANTHEM
MEDICAID 09320300 ANTHEM

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