Individual
DR. JOHN FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
989 RIBAUT RD STE 210, BEAUFORT, SC 29902-5481
(843) 524-8151
(843) 524-1954
Mailing address
106 CAPERS ST, BEAUFORT, SC 29902-5202
(843) 524-8151
(843) 524-1954
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
075723
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075723/PA0726
—
SC
Enumeration date
08/04/2006
Last updated
01/12/2012
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