Individual
JOHN FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
219 N BROAD ST, 2ND FLOOR, PHILADELPHIA, PA 19107-1519
(215) 762-5080
(215) 561-8071
Mailing address
1601 CHERRY ST, SUITE 11511, PHILADELPHIA, PA 19102-1321
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD042292L
PA
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD042292L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001214146
—
PA
Enumeration date
05/04/2006
Last updated
09/13/2016
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