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Individual
DR. JUAN D FUENTES
Active
Individual
DR. JUAN D FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
170972-1205
UT
2085R0202X
Diagnostic Radiology Physician
170972-1205
UT
2085R0202X
Diagnostic Radiology Physician
M-10423
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07685
—
UT
Enumeration date
06/07/2006
Last updated
09/04/2012
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