Individual
ANDREA STEPHANIE FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
200300151
NC
207VG0400X
Gynecology Physician
Primary
200300151
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10134901
—
VA
01
—
135T4
BCBS
—
05
—
3810001618
—
WV
01
—
7137758
AETNA
—
01
—
803615
PARTNERS
—
05
—
89135T4
—
NC
01
—
E0941
MEDCOST
—
05
—
Q51003
—
SC
Enumeration date
11/22/2005
Last updated
06/29/2010
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