Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301072612 | MI |
N | 111NI0900X | Internist | 4301072612 | MI |
Y | 207RH0003X | Hematology & Oncology | 4301072612 | MI |
NPI | 1063452522 |
---|---|
Provider Name | Joseph Albert Fontana |
First Address | Troy, MI 48083-1138 |
Second Address | Detroit, MI 48201-2013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 25/10/2016 |