Provider Demographics
NPI:1508279522
Name:REYES GENERE, JUAN PABLO (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:PABLO
Last Name:REYES GENERE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-747-2066
Mailing Address - Fax:314-747-1277
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV IM GASTROENTEROLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-747-2066
Practice Address - Fax:314-747-1277
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2024-04-25
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Provider Licenses
StateLicense IDTaxonomies
MO2020013862207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200084886Medicaid