MEDICARE: DR. PATRICIA LYNN FONTAINE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	24058	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10000056	OTHER	MN	PREFERRED ONE
2	21783	OTHER	MN	ARAZ
3	HP21964	OTHER	MN	HEALTHPARTNERS
4	01-04920	OTHER	MN	MEDICA CHOICE & PRIMARY
5	102650	OTHER	MN	UCARE

General Provider Information

NPI Number	:	1073543518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA LYNN FONTAINE M.D.

Provider Business Mailing Address
First Line	:	1020 W BROADWAY AVE
Second Line	:	UMPHYSICIANS BROADWAY FAMILY MEDICINE
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2504
Country	:	US
Telephone Number	:	612-302-8200
Fax Number	:	612-302-8275

Provider Business Practice Location Address
First Line	:	1020 W BROADWAY AVE
Second Line	:	UMPHYSICIANS BROADWAY FAMILY MEDICINE
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2504
Country	:	US
Telephone Number	:	612-302-8200
Fax Number	:	612-302-8275

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	07/09/2007

Similar Medicare Providers

1598617227 — AMY S PETERSON LADC
Practice Location Address:

1020 W BROADWAY AVE
MINNEAPOLIS, MN
55411-2504

Practice Phone: 612-895-3850
Practice Fax:

1851393672 — JEAN YEUNG MOON PHARM.D.
Practice Location Address:

1020 W BROADWAY AVE
MINNEAPOLIS, MN
55411-2504

Practice Phone: 612-302-8361
Practice Fax: 612-302-8277

1952345639 — GEOFFREY THOMAS ABBOTT LICSW
Practice Location Address:

1020 W BROADWAY AVE , UMPHYSICIANS BROADWAY FAMILY MEDICINE
MINNEAPOLIS, MN
55411-2504

Practice Phone: 612-302-8200
Practice Fax: 612-302-8275

1083640833 — DR. ROBERT B. LEVY M.D.
Practice Location Address:

1020 WEST BROADWAY AVE , UNIVERSITY OF MINNESOTA
MINNEAPOLIS, MN
55411-2504

Practice Phone: 612-302-8200
Practice Fax: 612-521-4725

1659395903 — DR. PHILIP J FALLT MD
Practice Location Address:

1020 W BROADWAY
MINNEAPOLIS, MN
55411-2504

Practice Phone: 612-302-8200
Practice Fax: 612-302-8275

1245320753 — LUANN M OKRINA-KIBIRA NP
Practice Location Address:

1020 W BROADWAY AVE
MINNEAPOLIS, MN
55411-2504

Practice Phone: 612-302-8200
Practice Fax:

Directions to “ DR. PATRICIA LYNN FONTAINE M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.