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Individual

VIVIAN L. FERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3000 WATERCOVE RD, MIDLOTHIAN, VA 23112-3982
(804) 744-0200
(804) 744-8417
Mailing address
3000 WATERCOVE RD, MIDLOTHIAN, VA 23112-3982
(804) 744-0200
(804) 744-8417

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101034450
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0100286
UNITED HEALTHCARE
VA
01
10488
CIGNA
VA
01
116047
ANTHEM
VA
01
540189
AETNA
VA
01
540883363
CHAMPUS-TRICARE
VA
05
5633842
VA
01
60534
OPTIMA
VA
01
82535
SOUTHERN HEALTH
VA
01
856731
MAMSI
VA
Enumeration date
05/16/2006
Last updated
07/19/2013
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