Individual
ERIC FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1310 MIDDLEFORD RD, SUITE 101, SEAFORD, DE 19973-3670
(302) 629-5700
(302) 629-6001
Mailing address
1310 MIDDLEFORD RD, SUITE 101, SEAFORD, DE 19973-3670
(302) 629-5700
(302) 629-6001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0003121
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407275530
—
DE
01
—
346204YBWE
MEDICARE
DE
01
—
K7520021
CAREFIRST
DE
01
—
P01401462
RR MEDICARE
DE
Enumeration date
04/16/2014
Last updated
02/24/2016
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