Individual
ADOLFO ZACARIAS FERNANDEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-6637
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-6637
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
200300597
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10012252
—
VA
01
—
134GC
BCBS
—
05
—
2005465000
—
WV
01
—
7989604
AETNA
—
01
—
802973
PARTNERS
—
05
—
89134GC
—
NC
01
—
C6800
MEDCOST
—
Enumeration date
12/13/2005
Last updated
11/12/2010
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