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NPI Code Detail

MEDICARE: DR. JOSE FERNANDO CORDERO MD, MPH

MEDICARE: DR. JOSE FERNANDO CORDERO MD, MPH
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
1208000000XPediatrics Physician022533GA

General Provider Information

NPI Number : 1528268943
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE FERNANDO CORDERO MD, MPH
Provider Business Mailing Address
First Line : 2320 PERIMETER PARK DR
Second Line :
City : ATLANTA
State : GA
Zip : 30341-1317
Country : US
Telephone Number : 404-285-2138
Fax Number :
Provider Business Practice Location Address
First Line : 2320 PERIMETER PARK DR
Second Line :
City : ATLANTA
State : GA
Zip : 30341-1317
Country : US
Telephone Number : 770-393-9901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2007
Last Update Date : 07/23/2007

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