Individual
JAIRO OMAR FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
725 HIGHLAND AVE, 2ND FLOOR, WINSTON SALEM, NC 27101-4206
(336) 607-8501
Mailing address
4813 BRIDGTON PLACE DR, WINSTON SALEM, NC 27127-7009
(336) 201-8272
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2007-00117
NC
Other
Enumeration date
03/12/2007
Last updated
08/23/2007
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