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General NPI Number Information
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NPI Number | 1639396187
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Entity Type | Organization
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Legal Business Name | DENNIS L FERNANDEZ MD PC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 4025 PEPPERWOOD CIR SW SUITE C
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City | HUNTSVILLE
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State | AL
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Zip | 35801-7433
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Country | US
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Telephone | 256-882-1908
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Fax | 256-882-1907
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Provider Business Mailing Address
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Address Line | 4025 PEPPERWOOD CIR SW SUITE C
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City | HUNTSVILLE
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State | AL
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Zip | 35801-7433
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Country | US
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Telephone | 256-882-1908
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Fax | 256-882-1907
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS L FERNANDEZ
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Credential | M.D.
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Telephone | 256-882-1908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25395
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License Number State | AL
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