Individual
RICHARD D FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 WEST 8TH STREET, ROME, GA 30165
(706) 291-8702
(706) 291-6514
Mailing address
311 WEST 8TH STREET, ROME, GA 30165
(706) 291-8702
(706) 291-6514
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
ME004673
FL
207ZC0500X
Cytopathology Physician
ME004673
FL
207ZH0000X
Hematology (Pathology) Physician
ME004673
FL
207ZI0100X
Immunopathology Physician
ME0046703
FL
207ZM0300X
Medical Microbiology Physician
ME0046703
FL
207ZP0101X
Anatomic Pathology Physician
ME004673
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME004673
FL
207ZP0104X
Chemical Pathology Physician
ME004673
FL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
78559
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042116200
—
FL
01
—
4122532
AETNA
FL
01
—
79997
BCBS OF FLORIDA
FL
05
—
G08967A
—
GA
01
—
L9266
BCBS FL
FL
01
—
P00745220
RAILROAD MEDICARE
FL
Enumeration date
10/24/2005
Last updated
10/14/2019
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