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NPI Code Detail

MEDICARE: EDGAR H HERNANDEZ M.D.

MEDICARE: EDGAR H HERNANDEZ M.D.
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
1208600000XSurgery Physician11305AZ

General Provider Information

NPI Number : 1861473506
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGAR H HERNANDEZ M.D.
Provider Business Mailing Address
First Line : PO BOX 6423
Second Line :
City : CHANDLER
State : AZ
Zip : 85246-6423
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 685 S DOBSON RD
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-5665
Country : US
Telephone Number : 480-821-2838
Fax Number : 480-821-9444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 11/14/2022

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