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General NPI Number Information
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NPI Number | 1831493022
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Entity Type | Organization
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Legal Business Name | DON J. FONTANA, M.D. PA
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Dates
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Enumeration Date | 01/01/2011
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 3500 OLD WASHINGTON RD SUITE 201
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City | WALDORF
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State | MD
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Zip | 20602-3238
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Country | US
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Telephone | 301-870-0600
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Fax | 301-870-0609
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Provider Business Mailing Address
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Address Line | 3500 OLD WASHINGTON RD SUITE 201
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City | WALDORF
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State | MD
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Zip | 20602-3238
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Country | US
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Telephone | 301-870-0600
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Fax | 301-870-0609
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DON FONTANA
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Credential | M.D.
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Telephone | 301-870-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | D0023431
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License Number State | MD
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