Individual
MARY ELIZABETH CORONEL HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500409 CHALAN KANOA, COMMONWEALTH HEALTH CENTER, SAIPAN, MP 96950
(670) 234-8950
(670) 234-8700
Mailing address
535 N MARINE CORPS DR, STE 1A, TAMUNING, GU 96913-4112
(671) 647-6669
(671) 647-6277
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0321
MP
2080P0214X
Pediatric Pulmonology Physician
0321
MP
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92873529
COLORADO MEDICAID PROGRAM
CO
Enumeration date
02/22/2007
Last updated
12/09/2020
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