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Individual

MR. FERNANDO A. DURALDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1336 HIGHWAY 54 W, BLDG 200, FAYETTEVILLE, GA 30214-4535
(770) 716-9656
(770) 716-1609
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
027370
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000439414E
GA
Enumeration date
07/29/2005
Last updated
01/15/2015
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