Individual
ORLANDO V FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 E TOLLISON ST STE B, BAXLEY, GA 31513-0150
(912) 367-0102
(912) 367-9966
Mailing address
PO BOX 2070, BAXLEY, GA 31515-2070
(912) 367-9841
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
043934
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000777543A
—
GA
01
—
110168355
RAILROAD MEDICARE
—
Enumeration date
03/23/2006
Last updated
04/29/2020
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