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NPI Code Detail

MEDICARE: MOUNTAIN MEDICAL SERVICES

MEDICARE: MOUNTAIN MEDICAL SERVICES
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
1174400000XSpecialist

General Provider Information

NPI Number : 1871645705
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNTAIN MEDICAL SERVICES
Provider Business Mailing Address
First Line : 354 BROADWAY
Second Line :
City : SARANAC LAKE
State : NY
Zip : 12983-1146
Country : US
Telephone Number : 518-897-1000
Fax Number : 518-897-2128
Provider Business Practice Location Address
First Line : 354 BROADWAY
Second Line :
City : SARANAC LAKE
State : NY
Zip : 12983-1146
Country : US
Telephone Number : 518-897-1000
Fax Number : 518-897-2128
Authorized Official
Title or Position : OWNER
Name : DR. MICHAEL POND
Credential : MD
Telephone Number : 518-897-1000
Provider Enumeration Date : 01/18/2007
Last Update Date : 02/18/2008

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Directions to “MOUNTAIN MEDICAL SERVICES ” Practice Location

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