Provider Demographics
NPI:1962472514
Name:POND, MICHAEL PM (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PM
Last Name:POND
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1927 SARANAC AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKE PLACID
Mailing Address - State:NY
Mailing Address - Zip Code:12946-1112
Mailing Address - Country:US
Mailing Address - Phone:518-523-7575
Mailing Address - Fax:518-523-7577
Practice Address - Street 1:1927 SARANAC AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKE PLACID
Practice Address - State:NY
Practice Address - Zip Code:12946-1112
Practice Address - Country:US
Practice Address - Phone:518-523-7575
Practice Address - Fax:518-523-7577
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2015-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY158672207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE47928Medicare UPIN
NYBA0289Medicare PIN