Individual
DR. CARLOS GUSTAVO FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1140 E MICHIGAN AVE STE 400, LANSING, MI 48912-1806
(517) 364-9650
(517) 364-9605
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-7999
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101016028
MI
207RI0011X
Interventional Cardiology Physician
Primary
5101016028
MI
Other
Enumeration date
04/30/2007
Last updated
04/19/2019
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