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Individual

DR. F D FORTUIN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
28581
AZ
207RI0011X
Interventional Cardiology Physician
Primary
28581
AZ

Other

Enumeration date
11/28/2005
Last updated
09/03/2020
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