Fernandez Decordova, Jorge
Fernandez Decordova, Jorge is an individual health care provider with primary practice located at 901 Macarthur , Munster IN 46321-2901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Fernandez Decordova, Jorge can be contacted via phone (219) 836-4622.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 01045112A | Indiana |
Profile Details
| NPI number | 1861487670 |
|---|---|
| LBN Legal business name | Fernandez Decordova, Jorge |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Dec 17th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861487670 | NPPES |
| Indiana | MEDICAID | 200131350 |
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