Individual
EDUARDO W FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1430 HIGHWAY 96 E, WHITE BEAR LAKE, MN 55110-3653
(651) 653-2100
(651) 653-2125
Mailing address
1430 HIGHWAY 96 E, WHITE BEAR LAKE, MN 55110-3653
(651) 653-2100
(651) 653-2125
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56869
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204466007
—
MO
Enumeration date
07/12/2007
Last updated
03/07/2023
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