Healthcare Provider Details

I. General information

NPI: 1962199687
Provider Name (Legal Business Name): HEVANSHI FERNANDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 HOSPITAL RD
COAL TOWNSHIP PA
17866-9668
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-214-9585
  • Fax: 570-214-9519
Mailing address:
  • Phone: 570-214-9585
  • Fax: 570-214-9519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD493189
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: