Individual
JULIAN HERNANDEZ CARVAJAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
(563) 421-6610
(563) 421-7719
Mailing address
PO BOX 4028, ROCK ISLAND, IL 61204-4028
(563) 355-9200
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
083662
IA
363A00000X
Physician Assistant
PA61456947
WA
Other
Enumeration date
08/03/2016
Last updated
07/31/2023
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