Provider Demographics
NPI:1487714150
Name:FOUNTAIN, MARGARET A (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:A
Last Name:FOUNTAIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:108 CROSS KEYS RD
Mailing Address - Street 2:SUITE 'E'
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1532
Mailing Address - Country:US
Mailing Address - Phone:410-435-0512
Mailing Address - Fax:410-323-1203
Practice Address - Street 1:EXECUTIVE CENTER AT HOOKS LANE
Practice Address - Street 2:2 RESEVOIR CIRCLE, SUITE 105
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208
Practice Address - Country:US
Practice Address - Phone:443-286-2969
Practice Address - Fax:410-323-1203
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD20156207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB69464Medicare UPIN
MD3321Medicare ID - Type Unspecified