Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | D000064008 | MD |
NPI | 1083657761 |
---|---|
Provider Name | Dr. Eddie Alejandro Fernandez |
First Address | Silver Spring, MD 20910 |
Second Address | Silver Spring, MD 20903-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 03/10/2019 |