Individual
ALAN P FONTANARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5544 GREENWICH RD STE 200, VIRGINIA BEACH, VA 23462-6563
(757) 466-0089
(757) 466-8017
Mailing address
5544 GREENWICH RD STE 200, VIRGINIA BEACH, VA 23462-6563
(757) 466-0089
(757) 466-8017
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003637
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10106950P
SENTARA HEALTH PLAN
VA
05
—
1437447158
—
VA
01
—
179CG
BCBSNC
NC
01
—
493396
BCBSVA
VA
01
—
P01196732
RAILROAD MEDICARE
VA
Enumeration date
07/15/2011
Last updated
02/07/2014
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