Individual
FE POBLETE FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
84 GRASSO PLZ, SAINT LOUIS, MO 63123-3108
(314) 638-9309
(314) 638-9333
Mailing address
84 GRASSO PLZ, SAINT LOUIS, MO 63123-3108
(314) 638-9309
(314) 638-9333
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35954
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201263464
—
MO
Enumeration date
05/23/2007
Last updated
01/13/2010
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