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1053360966
EDWIN L FUENTES
REIDSVILLE, NC
NPI
1053360966
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: VA 0102050134)
Enumeration Date
2006-05-08
Last Update Date
2023-07-25
Business Address
Dr. EDWIN L FUENTES D.O.
2509 RICHARDSON DR STE A
REIDSVILLE, NC 27320-5926
Phone number: 336-552-4274
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Mailing Address
Dr. EDWIN L FUENTES D.O.
109 DEER RUN RD
DANVILLE, VA 24540-2863
Phone number: 434-791-0306
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