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Individual

DR. DAVID W FONTAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
703 RIVERWAY PL, BEDFORD, NH 03110-6768
(603) 668-7096
(603) 669-6944
Mailing address
703 RIVERWAY PL, BEDFORD, NH 03110-6745
(603) 627-1661
(603) 669-6944

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11108
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01Y002791 NH05
ANTHEM MCH TAX ID
NH
01
01Y002791NH02
BLUE CROSS
NH
01
101250
TUFTS
NH
01
2486283
AETNA
NH
01
294664
CIGNA
NH
01
300113664
RAILROAD MEDICARE
NH
05
30201186
NH
Enumeration date
04/17/2006
Last updated
09/08/2023
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