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Individual
DR. THOMAS P FORTUNE
Active
Individual
DR. THOMAS P FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
010103908
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00414802
AETNA
VA
05
—
006037402
—
VA
01
—
094197
ANTHEM BCBS
VA
01
—
110026872
RAILROAD
VA
Enumeration date
09/11/2006
Last updated
11/13/2008
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