Individual
MARY BERNADETTE FORTINI
Active
Individual
MARY BERNADETTE FORTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
7826
NE
2080P0208X
Pediatric Infectious Diseases Physician
Primary
12831176-1204
UT
Other
Enumeration date
06/30/2016
Last updated
04/22/2024
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