Individual
DR. I. CLETUS M. FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 E RIVER ST, ELYRIA, OH 44035-5902
(440) 329-7500
Mailing address
630 E RIVER ST, ELYRIA, OH 44035-5902
(440) 329-7500
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35-042834
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0547706
—
OH
Enumeration date
04/26/2006
Last updated
06/09/2009
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