Fonseca, Peter

Fonseca, Peter is an sole proprietor health care provider with primary practice located at 12266 De Paul Dr Ste 205 , Bridgeton MO 63044-2514. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Fonseca, Peter can be contacted via phone (314) 647-8269.

Contact Information

Primary practice address
12266 De Paul Dr Ste 205 Bridgeton MO 63044-2514
Phone: (314) 647-8269
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 116658 Missouri

Profile Details

NPI number 1760483101
LBN Legal business name Fonseca, Peter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2005
Last updated Nov 5th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760483101 NPPES
Missouri MEDICAID 507190205

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