Individual
DR. ELISABETH FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12 CREST RD, ST ALBANS V, VT 05478
(802) 524-5523
(802) 524-5438
Mailing address
12 CREST RD, ST ALBANS, VT 05478
(802) 524-5523
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0420008922
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN0970
—
VT
Enumeration date
07/20/2006
Last updated
10/25/2013
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