Individual
JORGE ENRIQUE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 ACADEMY ST S, AHOSKIE, NC 27910-3248
(252) 209-3159
(252) 209-3049
Mailing address
PO BOX 1385, AHOSKIE, NC 27910-1385
(252) 209-3159
(252) 209-3049
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1384Y
BCBS OF NC
NC
01
—
194008
MEDCOST
NC
05
—
5900468
—
NC
Enumeration date
06/02/2006
Last updated
10/01/2007
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