Individual
DR. MARY C FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
HOSPITAL BASED @ COMMUNITY MEMORIAL, W180 N8085 TOWN HALL ROAD, MENOMONEE FALLS, WI 53051
(414) 805-3666
Mailing address
W180N8085 TOWN HALL RD, HOSPITAL BASED @ COMMUNITY MEMORIAL, MENOMONEE FALLS, WI 53051-3518
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
18322
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30118400
—
WI
Enumeration date
05/20/2006
Last updated
07/08/2007
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