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Individual

DR. FERNANDO CARLOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
190 WELLES ST, KINGSTON, PA 18704-4968
(570) 718-4140
(570) 718-4141
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD 0583251
PA
208000000X
Pediatrics Physician
Primary
MD058325L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1590725
PA
Enumeration date
06/30/2005
Last updated
08/25/2020
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