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1881061984
PETER PONOMAREV
SOUTHFIELD, MI
NPI
1881061984
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: MI 5302032680)
Enumeration Date
2015-08-25
Last Update Date
2015-08-25
Business Address
-- PETER PONOMAREV
15600 W 10 MILE RD UNIT 1B
SOUTHFIELD, MI 48075-2148
Phone number: 248-569-7578
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Mailing Address
-- PETER PONOMAREV
2516 BLACK PINE TRAIL DR
TROY, MI 48098-4102
Phone number:
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