Individual
ANNE D FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
154 EXTON SQUARE MALL, NEMOURS DUPONT PEDIATRICS, EXTON, EXTON, PA 19341-2440
(484) 565-8507
(610) 280-1531
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD071947L
PA
208D00000X
General Practice Physician
MD071947L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001862790
—
PA
Enumeration date
07/26/2006
Last updated
07/13/2016
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