Provider Demographics
NPI:1235306036
Name:VILLAFUERTE, RENATO G (MD)
Entity Type:Individual
Prefix:DR
First Name:RENATO
Middle Name:G
Last Name:VILLAFUERTE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3450 BRIDGELAND DRIVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63044
Mailing Address - Country:US
Mailing Address - Phone:314-770-1805
Mailing Address - Fax:314-770-0836
Practice Address - Street 1:3450 BRIDGELAND DRIVE
Practice Address - Street 2:SUITE G
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-770-1805
Practice Address - Fax:314-770-0836
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
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Provider Licenses
StateLicense IDTaxonomies
MOR7894207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine