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Individual

FERNANDINO LOUIS VILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1562 OPOSSUMTOWN PIKE, FREDERICK, MD 21702-4920
(240) 215-6310
Mailing address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 566-7754

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
0101287313
VA
208800000X
Urology Physician
01094508A
IN
208800000X
Urology Physician
2023010472
MO
208800000X
Urology Physician
Primary
D0100975
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200121997
MO
01
224040220
MEDICARE PTAN
IN
Enumeration date
04/07/2017
Last updated
10/13/2025
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