Individual
DR. MARK MICHAEL FERNANDEZ
Active
Individual
DR. MARK MICHAEL FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101251330
VA
207W00000X
Ophthalmology Physician
141993
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101251330
VIRGINIA MEDICAL LICENSE
VA
01
—
141993
NORTH CAROLINA MEDICAL BOARD CERTIFICATE NUMBER
—
05
—
1881860013
—
VA
Enumeration date
05/07/2008
Last updated
03/22/2018
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