Most Relevant Information
Provider Data
| NPI Number: | 1003443763 |
| Provider Name: | ANTHONY PETER DI PONIO DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/24/2020 |
| Last Updated: | 03/29/2021 |
Provider Practice Location
15855 19 MILE RD
CLINTON TOWNSHIP
MI
480383504
Practice Location Phone/Fax
| Phone: | 5862632300 |
| Fax: |
Provider Mailing Location
15855 19 MILE RD
CLINTON TOWNSHIP
MI
480383504
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |