Healthcare Provider Details

I. General information

NPI: 1578906244
Provider Name (Legal Business Name): ESEOSA CHRISTIANA FERNANDES MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 03/22/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MARYLAND MEDICAL CENTER 22 SOUTH GREENE ST
BALTIMORE MD
21201
US

IV. Provider business mailing address

22 S GREENE ST DEPT OF
BALTIMORE MD
21201-1544
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-8667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD477995
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number00000000000
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: