J Edson Pontes, MD
Urology in Detroit, MI. Individual provider (NPI-1).
NPI number1285681981
StatusActive
Last updated in NPPESApr 30, 2020
Details
- NPI
- 1285681981
- Entity type
- Individual (NPI-1)
- Name
- J Edson Pontes
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 28, 2006
- Certification date
- Apr 30, 2020
- Last updated
- Apr 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | 4301031303 | MI | Yes |
Practice location
4100 John R StDetroit, MI 48201-2013
Phone 800-527-6266 · Fax 313-966-8207
Mailing address
400 Mack BlvdSte 2 West Credentialing Dept
Detroit, MI 48201-2153
Phone 313-448-9006
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