Israel V. Fernando

NPI #1366749616 in Moline, Illinois

Provider Information

NPI Number: 1366749616
Entity Type: Organization
Organization Name: Israel V. Fernando
Primary Specialty: Dermatology
Enumeration Date: Feb 23, 2011
Last Updated: Feb 23, 2011

Practice Location

Address: 1588 37TH AVE
City: Moline
State: Illinois
ZIP Code: 61265-7213
Phone: (309) 797-2713

Authorized Official

Name: DR. ISRAEL V. FERNANDO, M.D.
Title: OWNER/PHYSICIAN
Phone: (309) 797-2713

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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