Individual
DR. MAURILIO HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1834 S CEDAR ST STE A, IMLAY CITY, MI 48444-9779
(810) 721-0000
(810) 721-0003
Mailing address
1834 S CEDAR ST, STE A, IMLAY CITY, MI 48444-9779
(586) 727-2761
(586) 727-3120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301095103
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154550911
—
MI
01
—
1235131137
BCBSM - BRONSON
MI
Enumeration date
07/14/2009
Last updated
12/17/2020
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