Provider Demographics
NPI:1477380947
Name:POUNDER, VIVIAN
Entity type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:
Last Name:POUNDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 JOE BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:GA
Mailing Address - Zip Code:39841-3838
Mailing Address - Country:US
Mailing Address - Phone:912-752-0006
Mailing Address - Fax:
Practice Address - Street 1:1305 BARNARD ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-6746
Practice Address - Country:US
Practice Address - Phone:912-752-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver