Individual
JUSTINO FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 SANDWICH ST, PLYMOUTH, MA 02360-2183
(508) 830-2120
Mailing address
PO BOX 9132, BROOKLINE, MA 02446-9132
(800) 927-0002
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36244
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2054175
—
MA
Enumeration date
01/17/2006
Last updated
12/28/2007
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