Individual
MARY E. FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-4967
(614) 293-5614
Mailing address
700 ACKERMAN RD, SUITE 385, COLUMBUS, OH 43202-1559
(614) 947-3700
(614) 947-3771
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35.029227
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163004
—
OH
Enumeration date
07/27/2006
Last updated
01/05/2010
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