Individual
DR. THOMAS P FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 PARK HILL DRIVE, FREDERICKSBURG, VA 22401
(540) 371-3010
(540) 899-9821
Mailing address
101 PARK HILL DRIVE, FREDERICKSBURG, VA 22401
(540) 371-3010
(540) 899-9821
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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