Individual
JUAN RENE FRONTERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20952 E 12 MILE RD, SUITE 200, ST CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Mailing address
20952 E 12 MILE RD, SUITE 200, ST CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301053764
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132311
PRIORITY HEALTH
MI
01
—
3235841007
CIGNA
MI
01
—
340019038
RAILROAD MEDICARE
MI
01
—
5733698
AETNA
MI
01
—
F10966
HAP
MI
Enumeration date
04/19/2006
Last updated
07/28/2008
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