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Individual

DR. DAVID FONTAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1061 HARMON AVE, FORT STEWART, GA 31314
(912) 435-6965
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H8640
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H8640
PHYSICIAN PERMIT
TX
Enumeration date
03/07/2007
Last updated
01/18/2019
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