Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | D15528 | MD |
NPI | 1205874898 |
---|---|
Provider Name | Fermin F Barrueto |
First Address | Baltimore, MD 21264-4075 |
Second Address | Towson, MD 21204-7701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 15/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
904200800 | (05) | MD |
D01319 | (02) | |
KT93/LT35 / 524468- | BC / BS OF MD (01) | MD |
S186 / S186 | BLUECHOICE (01) | MD |