Raymond Fada JR. O.D.

NPI 1013913094 - Optometrist - 152W00000X

NPI Details
NPI 1013913094
Gender Male
Enumeration Date 06/23/2005
Last Updated 11/18/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
6157 MID RIVERS MALL DR
202
SAINT PETERS MO, 63304-1105, US
Phone (636) 926-3647
Fax (636) 926-3684
Business Location
40 E NORTH ST
EUREKA MO, 63025-1205, US
Phone (636) 200-4393
Fax (636) 938-2650
Toxanomy
Taxonomy Code 152W00000X
License State Missouri
License Number T02848
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According to our database, Dr. Raymond Fada JR. O.D. NPI is 1013913094, taxonomy code is 152W00000X and license number is T02848, license state is located at Missouri. Raymond Fada JR. O.D. physically located at 6157 Mid Rivers Mall Dr, Saint Peters MO, 63304-1105. NPI Number Raymond Fada JR. O.D. has the Individual type.

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1013913094 NPI number is provided on an as is basis without warranty of any kind. 1013913094 is maintained by the National Plan & Provider Enumeration System. The contents of Raymond Fada JR. O.D. are for informational purposes only.