Fuentes, Juan D

Fuentes, Juan D is an individual health care provider with primary practice located at 5444 Green St , Murray UT 84123-5632. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Neuroradiology is his primary health care specialty. Fuentes, Juan D can be contacted via phone (801) 262-8120.

Contact Information

Primary practice address
5444 Green St Murray UT 84123-5632
Phone: (801) 262-8120
Fax: (801) 262-5721
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 170972-1205 Utah
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 170972-1205 Utah
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M-10423 Idaho

Profile Details

NPI number 1184664245
LBN Legal business name Fuentes, Juan D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Sep 4th, 2012 - about 12 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 1184664245 NPPES
Utah MEDICAID 07685

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