Provider Demographics
NPI:1780848259
Name:FONTANA, JUDY HELEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:HELEN
Last Name:FONTANA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:43151 DALCOMA DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6306
Mailing Address - Country:US
Mailing Address - Phone:586-286-8720
Mailing Address - Fax:586-649-6699
Practice Address - Street 1:50505 SCHOENHERR RD
Practice Address - Street 2:SUITE 325
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-3140
Practice Address - Country:US
Practice Address - Phone:586-580-1001
Practice Address - Fax:586-580-9289
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2015-02-09
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Provider Licenses
StateLicense IDTaxonomies
MI4301092497207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology