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Individual
HUMBERTO M FAGUNDES
Active
Individual
HUMBERTO M FAGUNDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
100121
MO
2085R0202X
Diagnostic Radiology Physician
100121
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100121
MO LICENSE
—
01
—
207947516
MCAID
—
01
—
32286
BNDD
—
01
—
33012444
CPIN
—
01
—
920004686
RRMEDICARE
—
Enumeration date
08/29/2006
Last updated
03/07/2023
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