Organization
ISRAEL FERNANDO MD
Active
Other names
Advanced Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
ISRAEL V FERNANDO M.D. (OWNER)
(309) 797-3713
Entity
Organization
Contact information
Practice address
825 N 6TH ST, BURLINGTON, IA 52601-4920
(319) 754-9028
(319) 754-9038
Mailing address
1588 37TH AVE, MOLINE, IL 61265-7213
(309) 797-2713
(309) 797-9558
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0268292
—
IA
Enumeration date
05/09/2006
Last updated
08/22/2020
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