Individual
DR. MIGUEL A FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
967 MINERAL SPRING AVE, NORTH PROVIDENCE, RI 02904-4934
(401) 312-0444
(401) 312-0446
Mailing address
967 MINERAL SPRING AVE, NORTH PROVIDENCE, RI 02904-4934
(401) 312-0444
(401) 312-0446
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD 8499
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004777
BLUE CHIP
RI
01
—
12-02799
UNITED HEALTH PLAN
RI
01
—
1680
NEIGHBORHOOD HEALTH PLAN
RI
01
—
22699-4
BLUE CROSS & BS
RI
01
—
406110
TUFTS
RI
05
—
MS47209
—
RI
Enumeration date
09/28/2006
Last updated
02/15/2012
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