Individual
EDEN FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3300 CENTENNIAL LN, ELLICOTT CITY, MD 21042-3600
(866) 389-2727
Mailing address
3300 CENTENNIAL LN, ELLICOTT CITY, MD 21042-3600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0004811
MD
Other
Enumeration date
09/13/2012
Last updated
06/10/2020
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