Healthcare Provider Details

I. General information

NPI: 1801057146
Provider Name (Legal Business Name): JOSHUA KIRAN FERNANDES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 MEDICAL PARK DR STE 303
SILVER SPRING MD
20902-4053
US

IV. Provider business mailing address

2101 MEDICAL PARK DR STE 303
SILVER SPRING MD
20902-4053
US

V. Phone/Fax

Practice location:
  • Phone: 318-325-2020
  • Fax: 318-388-0000
Mailing address:
  • Phone: 301-754-1200
  • Fax: 855-673-8462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0086891
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD046970
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD046970
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberD0086891
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: