Individual
XAVIER FONSECA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
4301507390
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
60745
MN
207RP1001X
Pulmonary Disease Physician
60745
MN
Other
Enumeration date
12/01/2014
Last updated
07/13/2022
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