Individual
DR. FRED ROANLD MONTERUBIO JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3009 N BALLAS RD, STE 356C, SAINT LOUIS, MO 63131-2322
(314) 432-2880
(314) 432-4810
Mailing address
3009 N BALLAS RD, STE 356C, SAINT LOUIS, MO 63131-2322
(314) 432-2880
(314) 432-4810
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R9A68
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-00217
MEDICARE COMPLETE
—
01
—
0700217
UNITED HEALTH CARE
—
01
—
101340
HEALTHLINK
—
01
—
112759
BLUE CROSS BLUE SHIELD
—
01
—
4217036
AETNA
—
01
—
46318
GROUP HEALTH PLAN
—
01
—
5143
HEALTHCARE USA
—
01
—
SP15678
CIGNA
—
Enumeration date
07/12/2005
Last updated
07/08/2007
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