Individual
SANTANA M FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3436 ISLETA BLVD SW, PMG ISLETA, ALBUQUERQUE, NM 87105-5837
(505) 462-7777
(505) 462-7880
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20020277
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63871289
—
NM
Enumeration date
10/03/2006
Last updated
07/16/2008
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