Individual
GWENDOLINE FONEBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5147
(208) 239-1720
(208) 239-1726
Mailing address
P.O. BOX 4168, POCATELLO, ID 83205-4168
(208) 239-1035
(208) 239-3626
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2018-02128
NC
207R00000X
Internal Medicine Physician
2061778
ID
207RX0202X
Medical Oncology Physician
2018-02128
NC
207RX0202X
Medical Oncology Physician
Primary
2061778
ID
Other
Enumeration date
06/28/2011
Last updated
07/31/2025
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