Individual
AMY MARIE FERNOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4160 CARMICHAEL RD, MONTGOMERY, AL 36106-3638
(334) 747-7440
Mailing address
301 BROWN SPRINGS RD, MONTGOMERY, AL 36117-7005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01089959A
IN
208600000X
Surgery Physician
Primary
3715
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233690190
MEDICARE PTAN
IN
05
—
300074861
—
IN
Enumeration date
03/25/2018
Last updated
08/20/2024
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