Individual
GREGORY FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 BOTULPH LN, SANTA FE, NM 87505-6912
(631) 259-1995
Mailing address
401 BOTULPH LN, SANTA FE, NM 87505-6912
(631) 259-1995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A167447
CA
Other
Enumeration date
06/03/2010
Last updated
01/25/2023
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