MEDICARE: NELSON J PONT DPM PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP1100X	Podiatric Clinic/Center

General Provider Information

NPI Number	:	1235398504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NELSON J PONT DPM PC

Provider Business Mailing Address
First Line	:	8623 N TELEGRAPH
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127
Country	:	US
Telephone Number	:	313-563-3750
Fax Number	:

Provider Business Practice Location Address
First Line	:	8623 N TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-1489
Country	:	US
Telephone Number	:	313-563-3750
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NELSON J PONT
Credential	:
Telephone Number	:	313-563-3750

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	10/06/2008

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