Organization
HYDRXAFUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOWANNA FONTENOT MD (MEDICAL DIRECTOR/PHYSICIAN)
(443) 699-0321
Entity
Organization
Contact information
Practice address
49 OLD SOLOMONS ISLAND RD STE 104, ANNAPOLIS, MD 21401-3861
(443) 699-0321
Mailing address
49 OLD SOLOMONS ISLAND RD STE 104, ANNAPOLIS, MD 21401-3861
(443) 699-0321
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
Other
Enumeration date
03/28/2019
Last updated
05/13/2019
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