Provider Demographics
NPI:1659437341
Name:FUCHS, LARA R (MD)
Entity Type:Individual
Prefix:DR
First Name:LARA
Middle Name:R
Last Name:FUCHS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6219 PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-4802
Mailing Address - Country:US
Mailing Address - Phone:917-570-4597
Mailing Address - Fax:
Practice Address - Street 1:915 N. GRAND RM C132
Practice Address - Street 2:VA HOSPITAL MENTAL HEALTH SERVICE
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-3146
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2255672084P0800X
MO20090076542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry