Provider Demographics
NPI:1316927593
Name:POMICTER, GREGORY RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:RYAN
Last Name:POMICTER
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 1:18300 WICKHAM RD
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-3100
Mailing Address - Country:US
Mailing Address - Phone:207-450-9026
Mailing Address - Fax:
Practice Address - Street 1:8901 ROCKVILLE PIKE WRNMMC
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-2342
Practice Address - Country:US
Practice Address - Phone:301-295-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-22
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0076789207L00000X
DCMD044414207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology