Individual
DR. HERNAN JOHN JIMENEZ-MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
568 RUIN CREEK RD, SUITE 128, HENDERSON, NC 27536-2880
(252) 436-1380
(252) 436-1581
Mailing address
568 RUIN CREEK RD, SUITE 128, HENDERSON, NC 27536-2880
(252) 436-1380
(252) 436-1581
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2007-00878
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0184009
—
OH
01
—
1417179730
GROUP NPI
OH
Enumeration date
06/23/2005
Last updated
07/23/2012
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