Individual
LAURENCE J FUORTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25114
IA
207RP1001X
Pulmonary Disease Physician
25114
IA
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
25114
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251959
—
IA
01
—
25195
WELLMARK BCBS
IA
Enumeration date
11/09/2005
Last updated
11/30/2007
Update your record
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