Provider Demographics
NPI:1851492730
Name:FONTAINE, JULIETTE SAVON (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIETTE
Middle Name:SAVON
Last Name:FONTAINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 18TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-6516
Mailing Address - Country:US
Mailing Address - Phone:202-785-2400
Mailing Address - Fax:202-785-0503
Practice Address - Street 1:1327 18TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6516
Practice Address - Country:US
Practice Address - Phone:202-785-2400
Practice Address - Fax:202-785-0503
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD21238174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist