Individual
DR. JUAN JOSE PINEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3300 VAWTER SCHOOL RD, COLUMBIA, MO 65203-8609
(573) 445-9764
Mailing address
3300 VAWTER SCHOOL RD, COLUMBIA, MO 65203-8609
(573) 445-9764
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R3P42
MO
207RG0100X
Gastroenterology Physician
Primary
R3P42
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110212405
RAILROAD MEDICARE
MO
05
—
206996613
—
MO
01
—
251779
HEALTHLINK
MO
01
—
6520
BLUE CROSS/BLUE SHIELD/MO
MO
Enumeration date
06/21/2005
Last updated
08/15/2022
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