Organization
FAMILY MEDICINE CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO AUGUSTO HERNANDEZ MD (MD)
(704) 359-7426
Entity
Organization
Contact information
Practice address
18509 STATESVILLE RD STE B1, CORNELIUS, NC 28031-5703
(704) 359-7426
Mailing address
18509 STATESVILLE RD STE B1, CORNELIUS, NC 28031-5703
(704) 359-7426
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
201000567
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100062480
—
KY
Enumeration date
07/27/2010
Last updated
09/30/2010
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