Individual
DR. FERNANDO DE LA TORRE UGARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1902 MAY ST, MARYSVILLE, KS 66508-1200
(785) 562-2517
(785) 562-5149
Mailing address
708 N 18TH ST, MARYSVILLE, KS 66508-1338
(785) 562-2517
(785) 562-5149
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
04-24207
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023499
BC/BS KS
KS
05
—
100135440A
—
KS
05
—
10025891000
—
NE
01
—
20592
BC/BS NE
NE
Enumeration date
08/01/2006
Last updated
05/25/2016
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