Individual
DR. JUAN O HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 HEALTH PARK DR STE 301, OWOSSO, MI 48867-1293
(989) 723-3613
(517) 364-9605
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-9650
(517) 364-9605
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301054500
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4456946
—
MI
Enumeration date
07/14/2005
Last updated
09/19/2019
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