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NPI Code Detail

MEDICARE: ANNE D FERNANDO MD

MEDICARE: ANNE D FERNANDO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianMD071947LPA
2208D00000XGeneral Practice PhysicianMD071947LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215951330
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE D FERNANDO MD
Provider Business Mailing Address
First Line : PO BOX 191
Second Line : PROVIDER ENROLLMENT DEPARTMENT
City : ROCKLAND
State : DE
Zip : 19732-0191
Country : US
Telephone Number : 302-651-6212
Fax Number : 302-651-4945
Provider Business Practice Location Address
First Line : 154 EXTON SQUARE MALL
Second Line : NEMOURS DUPONT PEDIATRICS, EXTON
City : EXTON
State : PA
Zip : 19341-2440
Country : US
Telephone Number : 484-565-8507
Fax Number : 610-280-1531
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/13/2016

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Directions to “ ANNE D FERNANDO MD” Practice Location

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