Male or Other

Taylor Fontaine PA-C

Physician Assistant in Fargo, ND(View on Map)

Full Name

Taylor Fontaine PA-C

NPI Number

1033593025

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/20/2015

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Minnesota
North Dakota

License Number

11875
PAC0603

Contact
Information

Purpose

Mailing
Location

Address

1800 21ST AVE S
1800 21ST AVE S

City

Fargo
Fargo

State

ND
ND

Postal Code

58103-5759
58103-5759

Country

US
US

Telephone Number

(701) 365-8700
(701) 365-8700

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/17/2018

Provider Address

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