Provider Demographics
NPI:1417911504
Name:PIMENTEL-YAGER, FE MARIA A (MD)
Entity Type:Individual
Prefix:
First Name:FE MARIA
Middle Name:A
Last Name:PIMENTEL-YAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FE MARIA
Other - Middle Name:A
Other - Last Name:PIMENTEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 MEDICAL DR
Mailing Address - Street 2:PO BOX 311
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-6877
Mailing Address - Country:US
Mailing Address - Phone:573-231-3855
Mailing Address - Fax:573-231-3823
Practice Address - Street 1:100 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6877
Practice Address - Country:US
Practice Address - Phone:573-231-3855
Practice Address - Fax:573-231-3823
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080024502084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH08634Medicare UPIN
MO137720026Medicare PIN