Peralta, Enrique
Peralta, Enrique is an individual health care provider with primary practice located at 11710 Old Ballas Rd Suite 102, Saint Louis MO 63141-7076. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Peralta, Enrique can be contacted via phone (314) 569-2020.Contact Information
Primary practice address
11710 Old Ballas Rd Suite 102
Saint Louis MO 63141-7076
Phone: (314) 569-2020
Fax: (314) 569-1596
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 2004012770 | Missouri |
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 036-112111 | Illinois |
Profile Details
NPI number | 1346237534 |
---|---|
LBN Legal business name | Peralta, Enrique |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 3rd, 2005 |
Last updated | Feb 8th, 2011 - about 13 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1346237534 | NPPES |
Missouri | MEDICAID | 209310200 | |
Missouri | MEDICAID | 036112111 |
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