Provider Demographics
NPI:1174968937
Name:PONTZER, PETER FRIERY (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:FRIERY
Last Name:PONTZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2114
Mailing Address - Country:US
Mailing Address - Phone:814-695-1281
Mailing Address - Fax:814-696-3588
Practice Address - Street 1:716 WALNUT ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-2114
Practice Address - Country:US
Practice Address - Phone:814-695-1281
Practice Address - Fax:814-696-3588
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA008806-E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine