Individual
SANDRA JANE FORTNA
Active
Individual
SANDRA JANE FORTNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD043028L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025768502
UNIVERA
NY
05
—
001406477
—
PA
05
—
0940183
—
OH
01
—
1039836
GATEWAY
PA
01
—
1071715
WEST VIRGINIA WORKERS COMP
WV
01
—
1770316
AETNA
PA
01
—
20089138
AMERIHEALTH MERCY-WMG
PA
01
—
210777
UNISON
PA
01
—
268092
UNISON-WMG
PA
01
—
313005
UPMC
PA
01
—
733398
BLUE SHIELD
PA
01
—
949364
CAREFIRST MD BCBS
MD
01
—
P00440841
RR MEDICARE
PA
Enumeration date
04/13/2006
Last updated
11/10/2010
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