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Individual

MR. FRANK FORTIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
8101 HINSON FARM RD, ALEXANDRIA, VA 22306-3403
(703) 765-4321
Mailing address
8926 WOODYARD RD, SUITE 701, CLINTON, MD 20735-4220
(301) 856-1682

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001280
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0110001280
VIRGINIA LICENSE
01
1024354
NCCPA CERTIFICATION #
Enumeration date
08/10/2009
Last updated
06/06/2011
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