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Individual

BRADLEY FERNANDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-2119
Mailing address
4517 MACARTHUR BLVD NW, WASHINGTON, DC 20007-7205
(805) 542-9843

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN1043961
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN1043961
DOH
DC
Enumeration date
01/09/2019
Last updated
01/09/2019
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