Individual
DR. PATRICIA LYNN FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1020 W BROADWAY AVE, UMPHYSICIANS BROADWAY FAMILY MEDICINE, MINNEAPOLIS, MN 55411-2504
(612) 302-8200
(612) 302-8275
Mailing address
1020 W BROADWAY AVE, UMPHYSICIANS BROADWAY FAMILY MEDICINE, MINNEAPOLIS, MN 55411-2504
(612) 302-8200
(612) 302-8275
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24058
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-04920
MEDICA CHOICE & PRIMARY
MN
01
—
10000056
PREFERRED ONE
MN
01
—
102650
UCARE
MN
01
—
21783
ARAZ
MN
01
—
HP21964
HEALTHPARTNERS
MN
Enumeration date
07/03/2006
Last updated
07/09/2007
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