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Individual
RODERICK W FONTENETTE
Active
Individual
RODERICK W FONTENETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01069587A
IN
207P00000X
Emergency Medicine Physician
Primary
147303
CA
207P00000X
Emergency Medicine Physician
35 096666
OH
207P00000X
Emergency Medicine Physician
MD.203768
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201021810
—
IN
Enumeration date
09/23/2008
Last updated
05/17/2019
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