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General NPI Number Information
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NPI Number | 1871645705
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Entity Type | Organization
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Legal Business Name | MOUNTAIN MEDICAL SERVICES
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 354 BROADWAY
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City | SARANAC LAKE
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State | NY
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Zip | 12983-1146
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Country | US
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Telephone | 518-897-1000
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Fax | 518-897-2128
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Provider Business Mailing Address
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Address Line | 354 BROADWAY
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City | SARANAC LAKE
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State | NY
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Zip | 12983-1146
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Country | US
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Telephone | 518-897-1000
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Fax | 518-897-2128
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL POND
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Credential | MD
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Telephone | 518-897-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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