Individual
NELSON CHEN FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
46A BROAD STREET RD, MANAKIN SABOT, VA 23103-2213
(804) 708-9480
(804) 708-0865
Mailing address
PO BOX 5275, GLEN ALLEN, VA 23058-5275
(804) 708-9480
(804) 708-0865
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101248696
VA
207Q00000X
Family Medicine Physician
01067690A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417147315
—
VA
Enumeration date
07/26/2007
Last updated
09/30/2015
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