PETER FONSECA

BRIDGETON, MO
NPI1760483101
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
(Licence: MO  116658)
Enumeration Date2005-08-09
Last Update Date2020-11-05
Business Address
DR. PETER FONSECA M.D.
12266 DE PAUL DR STE 205
BRIDGETON, MO 63044-2514
Phone number: 314-647-8269
Mailing Address
DR. PETER FONSECA M.D.
PO BOX 955534
SAINT LOUIS, MO 63195-5534
Phone number:
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