MEDICARE: BRUNILDA CORDERO 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
1	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	27876	SC
2	2080P0205X	Pediatric Endocrinology Physician	2005-01160	NC

General Provider Information

NPI Number	:	1619074408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUNILDA CORDERO MD

Provider Business Mailing Address
First Line	:	101 ROBESON ST
Second Line	:	SUITE 410
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-5552
Country	:	US
Telephone Number	:	910-615-1885
Fax Number	:	910-321-6254

Provider Business Practice Location Address
First Line	:	101 ROBESON ST
Second Line	:	SUITE 410
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-5552
Country	:	US
Telephone Number	:	910-615-1885
Fax Number	:	910-321-6254

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/02/2025

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Directions to “ BRUNILDA CORDERO MD” Practice Location

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