Basic Information
Provider Information
NPI: 1447509203
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FUENTES BARROW
FirstName: ROCIO
MiddleName: CAROLINA
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
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Mailing Information
Address1: 911 E 20TH ST STE 300
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571051045
CountryCode: US
TelephoneNumber: 6053221300
FaxNumber: 6053221301
Practice Location
Address1: 6100 S LOUISE AVE STE 2100
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571086021
CountryCode: US
TelephoneNumber: 6055041100
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/07/2012
LastUpdateDate: 10/31/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106X11433SDY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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