Individual
RAPHAELA FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10 PATEWOOD DR STE 130, GREENVILLE, SC 29615-6317
(864) 455-8988
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
39379
SC
Other
Enumeration date
06/15/2016
Last updated
09/28/2020
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