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Individual

MILDRED THERESE FAJARDO

Active
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Individual

MILDRED THERESE FAJARDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
MD436495
PA
2084P0800X
Psychiatry Physician
Primary
MD436495
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1024996330001
PA
Enumeration date
05/11/2007
Last updated
07/11/2011
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