Individual
MR. HUMBERTO JOSE OLIVERO LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MSPH
Contact information
Practice address
611 WEST MAIN STREET, FREDERICKTOWN, MO 63645
(573) 783-3341
(573) 783-1096
Mailing address
611 WEST MAIN STREET, FREDERICKTOWN, MO 63645
(573) 783-3341
(573) 783-1096
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
2014025224
MO
207Q00000X
Family Medicine Physician
2014025224
MO
2083P0901X
Public Health & General Preventive Medicine Physician
2014025224
MO
2083X0100X
Occupational Medicine Physician
Primary
2014025224
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/08/2008
Last updated
11/12/2014
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